[Projectile in the common bile duct: a rare cause of cholestatic jaundice].
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Biomedical subjects
Publications and source records attributed to G Pin.
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Retrograde cholangiography was conducted in 310 patients early or late after biliary system surgery. Principal indications for the investigation were angiocholitis (37% of cases), isolated jaundice (30%) or acute hepatic colic (17%). Biliary tract lesions were excluded in 7% of patients while in the remaining 93% it was possible to determine the precise cause of the disorder. In 30% of cases the disorder was unrelated to the previous operation or the lithiasic disease, whereas in 63% it was related to the latter (remaining or reformed stone, odditis) or to the surgical procedure (stenosis, common bile duct ligature or injury to main bile duct). These results, and those reported in the ligature, suggest that retrograde cholangiography can provide a precise diagnosis and ensure adapted therapy after biliary surgery.
A 58-year-old man developed diarrhoea and duodenal ulcer related to a malignant pancreatic gastrinoma. Initial evaluations of basal acid output and serum gastrin level were not significant. Two months later they were typical of Zollinger-Ellison syndrome. The tumor was detected by endoscopic retrograde pancreatography.
Esophageal dilatations under topical pharyngeal anesthesia with the Eder-Puestow's metallic olives system were performed 101 times on 30 patients presenting peptic strictures. This method uses first a metallic wire introduced into the esophagus and the stomach under endoscopic control. Then, the wire allows to guide dilatating olives through very tight strictures. Functional results were excellent 28 times out of 30; two patients only required repeated dilatations because of uncomplete treatment (stenosis on esojejunal anastomosis). Finally, surgical procedure was never indicated. The use of Eder-Puestow's material together with fiberoptic esophagoscope reduces the hazard of peroral bougienage: no complication occured in our series.
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3 cases of inappropriate vasopressin secretion during one case of anaplastic carcinoma of the lung, one case of carcinoma of the prostate with bony metastases and one case of acute intermittent porphyria are presented. The plasma levels of vasopressin, measured by radioimmunoassay were high. Treatment with demeclocycline was attempted in one case. The clearance of free water was positive but the treatment was poorly tolerated by the digestive tract.
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The authors report a case of Menetrier's disease revealed in a 51 years woman before oedomas by systematic gastroscopy. Somes particularities of this case authorize to argue problems put by this disease: a thyroid nodule treated by L + triodothyronin; an eosinophilia; a biological study of gastric secretion, gastrin and intrinsec factor level; an hormonal, immunologic and genetic exploration; an histochimic and ultra-structural study of operative portion; its favorable evolution after total gastrectomy.
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Two cases of diffuse squamous cell carcinoma of the oesophagus simulating the roentgenographic appearance of oesophageal varices are presented. Careful fluoroscopic examination may permit accurate diagnosis; however if the lesions are equivocally demonstrated by X-ray examination, oesophagoscopy confirms the diagnosis of carcinoma. R94.