Biomedical subjects
H Ronsse
Publications and source records attributed to H Ronsse.
Proximal arterial dilatation developing after surgical closure of long-standing posttraumatic arteriovenous fistula.
Concomitant discovery of long-standing arteriovenous fistula (AVF) and proximal dilatation is commonplace whereas the disclosure of proximal arterial dilatation several years after closure of AVF is much more surprising and less often described. The goal of this study was to call attention to this late complication, to evaluate its prevalence, and to describe the mechanism and outcome after treatment. Six new observations were added to 11 cases already published in the literature. Most AVF were located in the popliteal or superficial femoral arteries. The mean duration of these AVF was 20 years and 7 months. The mean delay between closure of AVF and the discovery of arterial dilatation was 9 years and 8 months. One patient required emergency operation for rupture. Another patient sustained embolism. All patients were treated by exclusion-bypass. Six years after operation for arterial dilatation, one patient had to be reoperated on for impending rupture of an aortic aneurysm. These facts lead us to advocate 1) closure of all AVF, even when iatrogenic, whenever present for 45 days or longer, 2) careful observation of all patients after operation for long-standing AVF, 3) operation on all patients with arterial dilatation secondary to AVF, and 4) life-long surveillance of the proximal arteries of these patients.
[Thrombogenic thrombopenia induced by heparin].
Three cases of heparin induced thrombotic thrombocytopenia are reported. Pathogenesis, clinical and biological manifestations as well as treatment are reviewed. Treatment consisted in replacing the heparin by a vitamin K antagonist or a low molecular weight heparin. During heparin treatment, the risk of thrombotic thrombocytopenia should be kept in mind and the platelet count monitored from time to time.
[Noncancerous pathology of the ileocecal region].
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[Supra-selective vagotomy in the treatment of perforated duodenal ulcers. Thirty cases report (author's transl)].
Thirty patients with acute perforated duodenal ulcer were managed by supra-selective vagotomy and simple closure of the perforation. There was no operative mortality and a low morbidity. Fourteen patients have had gastric studies between four and thirty-two months after operation. Three patients had transitory epigastric fullness (21%); there was no diarrhea or dumping, but two recurrences (14%). The risk of ulcer recurrence after simple closure is high; supra-selective vagotomy as a definitive ulcer therapy, does not increase operative mortality, and has mild digestive sequelaes, for an acceptable rate of recurrence.
Adenomas of the ampulla of Vater in Gardner's syndrome--what is to be done?
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EEA stapler and omental graft in esophagogastrectomy: experience with 30 intrathoracic anastomoses for cancer.
Experience with the EEA stapler device used in 30 esophagogastric resections for cancer with intrathoracic anastomosis, is reported. The mortality rate was 13.3%. The anastomotic failure rate was 3.3% (1/30) with only one death; three asymptomatic blind fistulas were found on a routine contrast examination of the anastomosis. It is felt that esophagogastric EEA stapled anastomosis associated with an omental graft is a very safe technique.
[Compartmentalized portal hypertension after spleno-renal shunt occlusion (author's transl)].
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[Supra-selective vagotomy in the treatment of perforated duodenal ulcers. Thirty cases report (author's transl)].
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[Palliative U-tube intubation of tumours of the extrahepatic biliary tract (author's transl)].
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[Esophagogastrectomy with an EEA stapling device (author's transl)].
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[Mycotic aortic aneurysms (author's transl)].
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[Mechanical anastomosis with the EEA stapler in esophageal surgery].
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[Difficulties of the diagnosis of cancers of the male urethra. Apropos of 5 cases].
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Adenocarcinoma of the appendix: a radioendoscopic diagnosis.
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[Compartmentalized portal hypertension after spleno-renal shunt occlusion (author's transl)].
This is a report of a patient with a thrombosed distal spleno-renal shunt with gastro-splenic disconnection and post-operative recurrent variceal hemorrhage. After portocaval shunt, a high venous pressure in the gastro-splenic sector demonstrates a compartmentalized venous hypertension. Splenectomy normalized this segmental portal hypertension, this confirming the concept that this type of portosystemic shunt is selective in early post-operative period.
[Mycotic aortic aneurysms (author's transl)].
Mycotic aortic aneurysms were detected in four men aged between 47 and 73 years. The infective nature of the lesion was obvious in one case, while in the other three cases the diagnosis was suspected after radiological examination and confirmed by pathological and bacteriological investigations of the aneurysm wall. Radiological signs which suggest the presence of an infective aneurysm include rupture of the aneurysm, a rapidly progressing course, and unusual locations or morphology. Diagnosis is important as therapy differs from that of other types of aneurysm.