In cases when the pylorus area is significantly modified by the presence of the ulcerative lesions, frequently associated with hypertrophy of the pyloric sphincter, which does not allow to carry out in satisfactory conditions pyloroplasty of the Heinecke-Mikulicz type, the author introduces an improvement of the above mentioned technique by adding anterior sphincterectomy, obtained by a "cross like" incision of the pylorus. The final suture of the pyloroplasty is exclusively of the transversal type, in a single or in a double layer, when the lumina of the pylorus allows for such a suture.

Duodenal Ulcer↗

PubMedDate not supplied

[Colonic Crohn's disease, the total form].

A rectocolic localisation of the Crohn disease, total form-ulcero-granulomatous rectocolitis, which started an a colitic chronic syndrome with secondary anemia, is described. The radiological investigation shows aspects characteristic of the ulcero-granulomatous colitis (disappearance of the haustra coli and a relative stenosis of the sigmoid) (fig. 1 and 2). The biopsy from the superior mucous membrane of the rectum disclose an inflammatory chronic granulomatous process. A temporary derivative right subangulocolic transverse-right paraumbilical anus is performed (Iliescu). The biopsy from the colic wall at the level of the derivative anus shows the same inflammatory granulomatous chronic process. A medical treatment with salazopyrine and cortisone is carried ou for 6 months. Favourable course. Reexamined radiologically, the patient shows a quasi-complete stenosis of the left colic border and of the transverse up to the derivative anus (fig. 3 and 4). After one year of medical treatment, the problem will be contemplated of the eventual reestablishment of the transit by shunting only to the right colon and the superior rectum, the only areas spared for the moment by the cicatricial stenosis (fig. 5). The coding of the medical and surgical treatment in the extensive forms of the colic Crohn disease is discussed in the light of the world medical literature.

Colitis↗

PubMedDate not supplied

[Synchronous and metachronous cancers].

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Adult↗