[Cholestasis during josamycin treatment].
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Biomedical subjects
Publications and source records attributed to A Sée.
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In this report, we present a case of abdominal Castleman's disease determining lymphatic blockade and chylous ascites. On laparotomy, the tumour was considered as unremovable. Management of this unusual case included total parenteral nutrition, corticoïds, cyclophosphamide and antituberculous therapy. This treatment was followed by a dramatic improvement and disappearance of the ascitic effusion. Shrinkage of the tumour was demonstrated by repeated ultrasonography.
We report 2 cases of cerebral stroke in cirrhotic patients following endoscopic obturation of esophageal varices with Isobutyl-2-Cyanoacrylate. In both cases, hemiplegia appeared several hours after the procedure. A brain CT scan showed radiodense material in the cerebral arteries due to dissemination of Isobutyl-2-Cyanoacrylate. One patient died, the other improved slowly. Different hypotheses may be raised: defectuous injection into the arterial circulation, systemic emboli via portopulmonary venous shunts, delayed polymerization of Isobutyl-2-Cyanoacrylate. Systemic emboli have been reported previously following percutaneous transhepatic obliteration of esophageal varices, suggesting portopulmonary venous shunts. In spite of these 2 complications, this procedure remains useful in stopping acute variceal bleeding and in preventing recurrent bleeding.
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