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Biomedical subjects

A Pans

Publications and source records attributed to A Pans.

6 recordsLinked to original sources

A comparison of intraperitoneal prostheses for the repair of abdominal muscular wall defects in rats.

We compared the tissue response to the intraperitoneal implantation of three different prostheses (Gore-Tex, Mersilène, Vicryl-Mersilène) used to repair abdominal wall defects in rats. Vicryl-Mersilène is a new experimental prosthesis made of Dacron (Mersilène) coated with absorbable polyglactin (Vicryl). The least amount of adhesions to omentum and gut was found with Mersilène. Gore-Tex was responsible for the accumulation of neutrophils rather than macrophages mostly collected in close contact with Mersilène and Vicryl-Mersilène. Fibrosis, evaluated by histology and computerized morphometry, was mostly found with Vicryl-Mersilène. This should allow a better incorporation of Mersilène and a tighter anchorage to the abdominal wall, after Vicryl resorption.

Abdominal Muscles

[Acquired diverticulosis of the small bowel].

The authors report about their surgical experience? On the basis of one case of pneumascos and one case of gastrointestinal hemorrhage with collapse, for which no origin was found preoperatively and which was attributed to the presence of diverticula in the small bowel. The analysis of the literature shows that this rare condition (0.1% of the population) is mainly expressed as acute complications: diverticulitis, perforation, hemorrhage, obstruction. The treatment is surgical as a rule, but it can be medical if the condition is included in the scope of a malabsorption syndrome.

Aged

[Transsection of the cervical trachea secondary to a closed injury. Apropos of a case].

The successful surgical management of a case of complete blunt traumatic transection of the cervical trachea is reported. The management of this rare pathology is a real challenge for the surgeon with regard to early recognition of the lesion and proper therapeutic strategy. Except in case of respiratory distress and/or major laryngotracheal lesions, where urgent tracheotomy is recommended, diagnostic fiberoptic bronchoscopy should be performed to assess the lesions. Guided intubation can also be contemplated. It seems however more prudent to explore the trachea surgically under mask or IV (Ketalar) anesthesia with maintenance of spontaneous breathing. During this exploration intubation can be guided by the surgeon and general anesthesia be initiated. In cases of complete transection, end-to-end anastomosis using absorbable sutures, avoidance of protective tracheotomy and postoperative low-dose steroids seems to be the treatment of choice to avoid stenotic sequelae. If a postoperative stenosis occurs, it should be treated by laser before contemplating surgical correction.

Adult

[Surgical treatment of incarcerated inguino-crural hernia with interposition of a preperitoneal prosthesis].

For the last four years, 17 inguinal and femoral strangulated hernias have been treated at our institution by a median subumbilical incision. In all cases, a prosthesis has been placed by preperitoneal approach. An intestinal resection for irreversible necrosis has been performed in five patients. This procedure gives good control of the herniated organs, allows easy intestinal resection and good management of unforeseeable situations. The surgical exploration of the other hernial orifices and, if needed, their simultaneous treatment can be performed. Intestinal resection does not represent, in our opinion, an absolute contra-indication to the implantation of a prosthesis. In our study, the morbidity does not seem to be increased.

Adult

[Gallbladder volvulus].

We report two new cases of gallbladder volvulus. This rare condition principally affects elderly patients but is due to a congenital malformation related to the presence of a long mesocyst. Various factors such as kyphoscoliosis, multiparity and peristalsis of neighbouring organs favorise the occurrence of volvulus, the role of lithiasis is debatable. The diagnosis may be suggested on ultrasound but is most often confirmed at laparotomy. Diagnosis should be made rapidly in order to avoid progression towards a potentially fatal secondary peritonitis. Certain clinical elements such as the presence of a "floating mass" on palpation may suggest the diagnosis.

Aged