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Biomedical subjects

B Guiberteau

Publications and source records attributed to B Guiberteau.

27 records · Page 2Linked to original sources
PubMed1989

[Volvulus of the sigmoid colon].

The authors report of 34 cases of sigmoid colon volvulus occurring in young subjects (15%) and in elderly subjects (60% over the age of 75 years). The diagnosis is frequently suggested by the clinical features and the history (30% of patients have a history of a previous identical episode) and is confirmed by a plain abdominal x-ray and/or an opaque enema. Endoscopy is performed in every case, except in the presence of peritoneal signs, in an attempt to perform detorsion and colonic intubation under direct vision in order to avoid emergency surgery; this procedure is effective in 87% of cases. Emergency surgery has a high mortality rate (43.5%). Elective or deferred emergency surgery after preparation is much safer (6.6% mortality). In patients with multiple diseases, non-surgical conservative management after detorsion too frequently results in repeated complications, leading to decompensation of the concurrent illnesses and a mortality rate of 34%. Endoscopic detorsion followed by surgical resection after a short 3 to 4 day preparation seems to be the best guarantee of therapeutic success.

Adolescent↗
PubMed1989

[Pancreatic cancer with acinar cells. Apropos of 1 case with immunocytochemical study].

A case of acinar cell carcinoma of the pancreas in a 65 years old man is presented. The tumor occupies the area between spleen and porta hepatis. This observation is characterized by remarkable elevation of serum alpha foeto protein and C.T. scan and angiographic findings. In spite of complete resection and post operative immunotherapy (monoclonal antibodies) the patient developed with spread metastatic disease and died 6 months after surgery. The distinctive histological and immunocytochemical features of these tumors and the means of differentiating them from anaplastic duct cell carcinoma and islet cell carcinoma an discussed. Review of 26 well documented cases led to determine clinical, biological and pathologic aspects of these tumors. Histogenesis and differentiation with the others non duct type pancreatic tumors are discussed.

Aged↗
PubMed1989

[Retro-rectal cystic tumors of developmental origin in adults. Apropos of 2 cases].

Two cases of recto-rectal congenital developmental cysts are described in young women (37 and 38 years). One was a duplication cyst of the rectum in association with two epidermoid cysts detected by US exploration in an asymptomatic woman, during pregnancy. The other case was a Tailgut cyst revealed by a retro-rectal abcess. In two cases, a pelvic CT Scan with rectal barium instillation for contrast and MRI exploration, revealed relationships and components of the developmental cysts. The treatment was a complete surgical excision via a Karske's approach, with coccygeal resection.

Adult↗
PubMedDate not supplied

[Severe hemorrhage from gastroduodenal ulcer. Apropos of 100 cases].

Over a period of 7 years, 100 patients (70 males and 30 females; mean age 66 years) were operated for digestive tract haemorrhage originating in an ulcer. There was a past history of ulcer in 21% and 29% had been taking drugs known to have a toxic effect on the stomach. Patent bleeding was observed by endoscopy in 32% with clear arterial flow, or a visible vessel in 10. In 20 patients a fresh clot was observed. Surgery had been indicated for massive haemorrhage in 25 cases, for persistent bleeding in 27, for recurrent bleeding in 37 and due to a visible vessel in 11. Conservative treatment was possible in three-fourths of the cases. Gastrectomy was performed in 26. Follow-up was uneventful in 55. There were 18 cases with complications and 27 deaths factors leading to fatal outcome and the data reported in the literature were analyzed.

Adult↗
PubMedDate not supplied

[Management of patients over 75 years of age with digestive or abdominal disease. A series of 660 cases].

Over a period of 3 years, the authors cared for 660 patients over 75 years of age with diseases of the digestive tract. In 180 cases, the initial hospitalization had been previously planned and in 480 (72.7%) emergency admission was necessary. The diagnosis had not been confirmed in 90% of the emergency admissions. Half of the patients suffered from major illness (ASA III, IV). Planned hospitalization in a surgical unit involved cancer in 60% of the cases among which about one-half were colorectal cancers. In this latter group, mean hospitalization was 12 days and hospital mortality was 9.7%. For the patients with emergency admissions, diagnosis was only established after exploratory examinations (echography 296, endoscopy 205, opacification of the digestive tract 157...). No diagnosis could be established in 1.6% of the patients. Four types of emergency patients could be identified: occlusions 39.6%, painful abdomen 37%, haemorrhage 13.9% and jaundice 7.7%. In these groups, surgery was required in 64.7%, 69.1%, 72% and 40.5%, and mortality was 21.9%, 20.3%, 21.6% and 8.1% respectively. Duration of hospitalization was however similar (12 days). The overall mortality in this series was 14% (5.7% in non-operated patients and 16.7% in operated patients with a distinction between planned operations, 9.7%, and emergency operations, 20.3%). The two main risk factors were underlying disease and the need for emergency surgery. Age over 90 was also aggravated prognosis.

Abdomen↗