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Biomedical subjects

A Sibilly

Publications and source records attributed to A Sibilly.

At least 19 recordsLinked to original sources
PubMed1989

Pancreatic lithiasis: a rare cause of gastrointestinal hemorrhage.

The rare instance of a gastrointestinal hemorrhage caused by a lithiasis of the duct of Wirsung is described. The world literature records only 13 other cases. Pancreatic calculi cause hemorrhage by either migrating through the pancreatic parenchyma to perforate the duodenum, ulcerating the vessels of the periductal parenchyma, or rupturing the pancreas. The usual sign of this complication of chronic calcifying pancreatitis, difficult to diagnose, is repeated gastrointestinal hemorrhages and sometimes pain, as in epigastric colitis. The immediate therapy is control of the hemorrhage. With transcatheter occlusive techniques, radical surgery can be postponed until it is more tolerable.

Adult↗
PubMed1986

[Vascular malformations of the colon. A frequently undetected etiology of lower digestive hemorrhage].

Angiectasia of the right colon is a new entity which must be considered in cases of lower intestinal haemorrhage. Moore's classification is the one that is generally accepted today; it distinguishes between 3 types the most interesting and best individualized of which is type I. It consists of acquired lesions occurring after the age of 60, often multiple, localized in the right colon and frequently associated with aortic stenosis and atheroma. The diagnosis of these vascular malformations is usually delayed because the lesions are submucosal and not visible at endoscopy. Bimesaraic arteriography may show typical images where extravasation of contrast medium is associated with vascular tuft or "tuff". Even the anatomicopathological confirmation of the diagnosis is difficult, since the lesion can only be located by special techniques, such as intra-arterial injection of a silicone-containing substance. Owing to the failure of modern techniques such as embolization, the only possible treatment is surgical, based on resection of the colonic segment involved.

Arteriovenous Malformations↗
PubMed1986

[Mechanical sutures in digestive surgery. A critical study].

An objective review of the experimental and clinical literature comparing stapled- and hand-sutured anastomoses in gastrointestinal surgery is presented. Experimental studies support the hypothesis that stapled-sutured lines heal by primary intention, thus avoiding the inflammatory time lag, and resulting in a stronger wound during the first post-operative week. In contrast, manual sutures always produce an early inflammatory reaction with a transitory rise in collagenase activity in the submucosa, which explains the particular fragility of the anastomosis during that phase. Nevertheless, it was difficult to find a concordance between this histological quality of the stapled suture line and clinical results. In oesophageal surgery, a slightly higher rate of stenosis and a lower rate of anastomotic leakage were observed. In gastric and colorectal surgery, the superiority of the stapled suture was not proved. However, in colorectal randomized studies, the presence of "withdrawn" group for which the stapler was the only technically possible alternative, provides undeniable proof that this technique is an indispensable adjunct in modern digestive surgery. Conversely, its value seems negligible in surgery of the small bowel or of the intraperitoneal colon where manual suturing remains the technique of choice.

Acute-Phase Reaction↗
PubMed1986

[Autotransplantation of the spleen. A new possibility in the conservative surgery of the spleen].

Conservative surgery to spleen is an ancient concept brought up-to date by improved knowledge of its fundamental roles in immunity and anti-bacterial defences. Suture of spleen and partial splenectomy ensure the best possible functional results but have technical limitations resulting frequently in splenectomy to provide hemostasis. Data from clinical and experimental studies and reports in the literature have demonstrated that autotransplantation of spleen is a simple, safe and effective method for preventing the true dangers of asplenia. Optimal results from autotransplantation of spleen are obtained when the injured organ is broken into small fragments which are then implanted into small spaces fashioned in the greater omentum. Clinical and biological tests to evaluate functional value of these transplants have shown that results approach those of a normal or sutured spleen. It is concluded that this procedure, which completes other conservative methods of splenic surgery, should definitely exclude hemostasis splenectomy from therapy of injuries to spleen.

Animals↗
PubMed1986

[Splenic pseudocysts. Apropos of a case].

The authors report a case of pseudocyst of the spleen. This is a rare entity which is part of nosological type of nonparasitic splenic cysts. It has most often a post-traumatic origin. The diagnosis is evoked in front of a mass of the left hypochondrium and has to be confirmed by further examinations, in particular by sonography and scanner. A microscopic examination of the surgical specimen is the only way to establish the diagnosis of a pseudocyst. The histological characteristic of pseudocyst is absence of epithelium. The splenic pseudocysts require a surgical treatment. In most cases, a splenectomy is performed. A the moment, cyst resection and partial splenectomies are performed by a few authors. This is the type of technique that we prefer especially when the patient is young.

Adult↗
PubMed1983

[Conservative surgery of the spleen].

Conservative surgery of the spleen only has to overcome certain prejudices to become generally accepted. Today, we are convinced of the essential role of the spleen in the body's anti-infection defence mechanisms and the surgeon now has the means to repair a damaged spleen. We report the simplicity, effectiveness and reliability of three techniques of splenorraphy. Two of these techniques are our own and have been well tested in very extensive animal experiments and in our first clinical applications. Capsular sutures or partial splenectomy can treat the great majority of the lesions seen. When this is not possible, devascularisation of the spleen or autotransplantation of the splenic tissue are simple palliative measures, although there functional value has not been clearly established. The results of this approach are now numerous with adequate follow-up and have revealed no complications, immediate or delayed, inherent in the technique.

Humans↗
PubMed1982

[Acute primary ulcer of the small intestine. Present concepts (author's transl)].

Acute primary ulcer of the small intestine is an exceptional occurrence. Diagnosis is established only after a complication occurs. In most instances, this complication is perforation of the gut. Acute primary ulcer of the small intestine is accurately defined by specific histologic criteria. It can be unequivocally distinguished from the many other causes of spontaneous perforation of the small intestine. Experimental studies, although numerous, have not improved understanding of pathophysiology. Nosologic classification remains unclear. Many features are similar to those encountered in acute peptic ulcer but stress is usually absent. Other features resemble those of transient necrotizing enterocolitis ; acute primary ulcer of the small intestine may be a very localized form of this latter condition. Ischemia seems to be the most significant factor. However, for an ulcer and finally perforation to occur, ischemia must probably be associated with a number of other factors.

Acute Disease↗
PubMed1982

[Prognostic features of upper gastro-intestinal hemorrhages in adult over 65 (author's transl)].

Some prognostic features out of 57 cases at upper gastrointestinal hemorrhage, in people more than 65 years old, are reported. The age has no significance but after 70, gastroduodenal ulcers represent the more frequent etiology, with a very particular severity in cases of chronic and acute gastric ulceration. The mortality is still high, mainly due to decompensation of pre-existent renal, cardio-vascular or pulmonary taints, frequent in aged people.

Age Factors↗
PubMed1981

[Prethoracic aesophagoplasty in incurable stenosis of aesophagus (author's transl)].

The dermato-oesophagoplasty had its hour of glory. The complexity of the dermato-oesophagoplasty has made it totally abandoned and it presents only a historic advantage today. However, the unexpected arrival after 45 years of a canceration of cutaneous duct like that was observed on the second case of dermato-oesophagoplasty published in France comes to solve some problems of pathogeny of a surgical technic that the authors analyse in the light of more recent labours on the oesophagoplasty.

Adolescent↗