[Kidney cancer invading the inferior vena cava. Thrombectomy and resection of the inferior vena cava with quadruple clamping].
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Biomedical subjects
Publications and source records attributed to H Viard.
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The authors report on a series of 14 cases (10 men and 4 women) of epiphrenic diverticula treated surgically over a period of 14 years. Size was variable and the neck was narrow in 7 cases, wide in 5, and very wide in 2. Four patients presented with a double diverticulum. The diverticula are normally found on the right side (9 cases), and underlying dyskinesia is always present, often accompanied by major or minor cardiospasm (11 cases) or reflux from sliding hiatal hernia (3 cases). No manometric exploration was carried out in this series. Management was based on physiopathological considerations - 6 diverticulectomies with 5 myotomies, 6 myotomies with no diverticulectomy. The approach was left thoracic in 7 cases and abdominal in the others. The mortality rate was zero, and functional results are good. They are all the better in that the diverticulectomy, the myotomy and the repair of the gastroesophageal reflux have now been performed.
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The benign clear cell tumor of the lung is an uncommon neoplasm. It is often confused, before histological analysis, with metastases. The data of one personal observation are similar to those of 19 other cases of the literature. This tumor which occurs with an equal frequency in adults of the two sexes is often asymptomatic. It is discovered after a systematic x-ray control of the lungs. It is located in the peripheral parenchyma and looks like a round, homogeneous, well delimited opacity. Its evolution is always favourable after surgical excision. The benign clear cell tumour is never identified before pathological study. This neoplasm 1 to 6 cm in diameter consists of a uniform proliferation of clear cells filled up with free of intra-vesicular glycogen. Its cytological and structural features are not the same as those of the other primitive bronchopulmonary tumours having an important clear cell contingent. The histochemical and ultra-structural studies are at the origin of three hypotheses; is the benign clear cell tumor an apudoma, a smooth muscular neoplasm or an adenoma of the terminal bronchioles?
In a series of 235 gastric cancer cases, 10 cases (4,2%) of cancer of the stump were discovered. Analysis of the results show that the length of time before appearance was always more than 15 years, and 24 years on average. There were no cases of cancer after gastroentero-anastomosis. As concerns pathogenesis, the authors stress the role of bile reflux and of the reduction in stomach acid secretion. They present in details their therapeutic management and insist on the necessity of fiberoptic detection among high risk cases : gastrectomy patients of over 15 years standing.
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In this case report of this exceptional complication of hepatic distomatosis, the authors point out the frequency and mechanism of this acute accident in the cycle of the parasite. Strong eosinophilia is useful from a diagnostic point of view in the context of an internal hemorrhage and especially for the preoperative recognition of a distomial granuloma, which is the sign of hepatic invasion by the parasite. They review the surgical therapeutic methods and also cover the treatment of subcapsular hematomas of the liver of whatever etiology: they stress conservative methods and the importance of ligature of the hepatic artery as a alternative to hepatectomy.
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An unusual case of a pleuro-pericardial cyst is reported. The mobile character of its shadow in thoracic chest x-rays and the sudden onset of the unilateral chest pain suggested that the cyst was pedunculated and twisted. This was confirmed by operation.
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