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Biomedical subjects

F Michot

Publications and source records attributed to F Michot.

At least 19 recordsLinked to original sources

[Disorders of relaxation of the lower esophageal sphincter appearing after resection of a mid-thoracic esophageal pulsion diverticulum].

A pulsion diverticulum of the mid-thoracic oesophagus was resected because of severe dysphagia. A subdiverticular myotomy was associated for the treatment of non-propagated oesophageal contractions, without oesophageal low-sphincter abnormalities. Three months post-operatively, the dysphagia was still present and manometry showed the absence of lower sphincter relaxation after 45 percent of deglutitions; a lower oesophageal sphincter myotomy was performed, resulting in correction of the dysphagia and of the sphincter relaxation abnormalities. The deficit of the inhibitory nervous mechanism, responsible for abnormalities of lower oesophageal sphincter relaxation, was present in the entire intramural oesophageal plexus, but, was not symptomatic at the level of the IOS prior to resection of the diverticulum.

Acute Disease

[Disorders of relaxation of the lower esophageal sphincter after resection of mediothoracic esophageal pulsion diverticulum].

A pulsion diverticulum of the mid-thoracic oesophagus was resected because of severe dysphagia. A subdiverticular myotomy was associated for the treatment of non-propagated oesophageal contractions, without oesophageal low-sphincter abnormalities. Three months post-operatively, the dysphagia was still present and manometry showed the absence of lower sphincter relaxation after 45 percent of deglutitions; a lower oesophageal sphincter myotomy was performed, resulting in correction of the dysphagia and of the sphincter relaxation abnormalities. The deficit of the inhibitory nervous mechanism, responsible for abnormalities of lower oesophageal sphincter relaxation, was present in the entire intramural oesophageal plexus, but, was not symptomatic at the level of the IOS prior to resection of the diverticulum.

Diverticulum, Esophageal

[Cystic lymphangiomas of the pancreas. Three new cases].

Cystic lymphangiomas are vascular dysembryoplastic lesions. Three pancreatic cases are reported. Preoperative diagnosis is rarely possible and laparotomy is mandatory. Complete resection prevents recurrence but excessively aggressive surgery is not required for this benign disease.

Adult

[The superior mesenteric artery syndrome. Apropos of a case and review of the literature].

During laparotomy for an appendicular peritonitis, the authors found an acute mesenteric artery syndrome. Conservative treatment consisted of mobilisation of the 4th part of the duodenum with section of the suspensory muscle of Treitz, but this was not sufficient to cure the patient. Two weeks later the patient completely recovered after a duodenojejunal anastomosis. A review of the literature confirmed that surgical treatment for scoliosis and anorexia nervosa play an important role in the aetiology of this disease.

Adult

[How to express the percentage of words expressing the frequency (or sensitivity) of symptoms in a disease?].

A prospective multicenter study concerning 30 vocabulary terms was undertaken to determine if: 1) these terms could be equated with specific percentages; 2) observer assessment varied with time; 3) teachers and students used the same words with the same meaning; 4) certain words were more discriminant than others, and 5) terms corresponding to numbers were the same in French as in English. Three hundred and thirty medical professionals, coming from general and digestive units of 45 University, regional, or private institutions, were asked to answer three types of questionnaires pertaining to the same 30 words, but in a different order. One to 3 months later, 170 of them were asked to fill out the same questionnaire with the same words but in a different order. Sixteen percent were University professors, 15 percent were hospital or private surgeons, 19 percent were senior residents, 29 percent were interns or junior residents and 21 percent were medical students.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance

[Gastric volvulus secondary to para-esophageal and sliding hiatal hernias].

Gastric volvulus is not a rare condition and 350 authentic cases have been documented in the adult population. Most often, gastric volvulus was associated with a large paraoesophageal hernia (40%). We report seven new cases of gastric volvulus: 5 were due to a large paraoesophageal hernia, 1 to mixed hiatus hernia, and 1 to a sliding hiatus hernia. We did not observe any cases of acute strangulation with gastric necrosis. The lesions were reversible in the three cases of acute and four cases of chronic gastric volvulus. Surgical treatment included gastric volvulus reduction and repair of hiatus hernia without gastric resection. Surgical treatment of paraoesophageal hiatus hernia is mandatory to reduce the incidence of gastric volvulus. The possibility of gastric volvulus with hiatus hernia must be recognized.

Female

[Role of duodenal diversion in the treatment of gastro-esophageal reflux].

Total duodenal diversion (TDD) is an original and efficient form of surgical treatment for gastroesophageal reflux. This technique was performed in 11 patients for severe esophagitis by first intention or after previous surgery. Results were excellent on reflux but 3 patients developed functional complications of the operation. This morbidity must lead to restrain the indications of the TDD.

Adult

[The role of colorectal resection in severe constipation after promontory rectopexy].

Abdominal rectopexy to the promontory is an effective treatment for total rectal prolapse, internal procidentia and solitary ulcer. This paper is designed to stress the risk of severe constipation following rectopexy, a complication which required surgical resection in 5 cases. This raises the problems of the physiological mechanisms of this complication, the definition of a possible high risk population (young women, patients who were constipated preoperatively?), and an alternative to promontory rectopexy: sacral fixation of the rectum, associated sigmoidectomy, Delorme's operation?

Adult

[Carney's triad: a new case associated with adrenal cortex adenoma].

Carney's triad is a combination of at least 2 of 3 tumor sites: multiple gastric leiomyoblastoma, pulmonary chondroma and paraganglioma, most often extra-adrenal and secreting. Thirty-three cases have been published; we report a new case in a 20 year-old woman, with multiple gastric leiomyoblastomas, liver metastasis, and bilateral pulmonary chondroma. The research of paraganglioma, in regard to Carney's disease, led to the discovery of corticoadrenal adenoma.

Adenoma

[Crohn disease: results of a series of 42 intestinal resections].

Forty-two patients underwent a resection for acute or chronic complications of Crohn's disease during the years 1983-1987. The colon was involved in 38% (16 patients), the small bowel in 31% (13 patients) and the ileocaecal region in 31%. In small bowel disease, the indication for operation was either an intestinal obstruction or an internal abscess. In colonic locations, poor response to medical therapy was the indication for operation in 10 patients (63%), and an acute complication in the remaining cases. The operations performed were always "radical resections": 13 resections of small bowel, 13 ileocaecal resections, 7 ileocolectomies with ileosigmoidostomies, 6 ileocolectomies with ileorectostomies, 2 left side hemicolectomies with colorectostomies and one total coloproctectomy. There was no operative mortality. A post-operative complication occurred in two patients (4.8%). The recurrence rate was 12% after 30 months average follow up in the 34 patients with only one operation for Crohn's disease. There was no second recurrence in the 8 patients operated for a first recurrence. The factors affecting recurrence after resection were: a short pre-operative time interval since first clinical symptoms: 4.6 years versus 5.3 years without recurrence (p less than 0.01); the colonic location of the Crohn's disease (p less than 0.02). Colonic location rate of the disease was found to be higher in this study as compared to others. Since "radical resection" fails to cure all patients, surgery should be restricted to acute on chronic complications.

Adolescent