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Biomedical subjects

J Grosdidier

Publications and source records attributed to J Grosdidier.

At least 19 recordsLinked to original sources
PubMed1992

Villous adenomatosis of duct of Wirsung revealed by wirsungorragie: evolution and surgical management.

A patient presenting with wirsungorragie was found to have a villous adenoma of the duct of Wirsung. The lesion was treated by a left pancreatectomy. Five years later he presented with recurrent wirsungorragie and was found to have a villous adenomatosis of the main pancreatic duct and of its side branches. This time a Whipple procedure was performed, achieving a total pancreatectomy. The patient has remained well for 12 months. This case of villous adenomatosis is, to our knowledge, the first one to be revealed by a wirsungorragie.

Adenoma↗
PubMed1991

[Bacteriological aspects of acute cholangitis with gallstones].

The bacteria found in the bile and blood of 45 patients (27 men, 18 women; mean age 69 years) suffering from acute cholangitis with gallstones were studied in order to determine the appropriate antibiotic therapy. Before any antibiotic was prescribed, a series of haemocultures was performed under aerobic and anaerobic conditions, and later gallbladder bile samples were taken during the operation. Blood cultures were positive in 55 percent of the cases and bile cultures in 84 percent. The bacteria most frequently encountered in blood were Escherichia coli, Klebsiella spp. and Bacteroides fragilis. The frequency of bacteria passage from bile to blood was studied and clearly showed a predominance of E. coli, Klebsiella and anaerobes. Enterococci passed into the blood stream only in very special circumstances, such as endoscopic sphincteromy or inadequate antibiotic therapy. To be effective, the antibiotic treatment should cover enterobacteriaceae, anaerobes and, if required, staphylococci. Enterococci can be ignored in most cases.

Acute Disease↗
PubMed1991

[Mesenteric and portal vein thrombosis following splenectomy in hematologic diseases. Apropos of 3 cases].

Mesenterico-portal venous thrombosis following hematological splenectomy is infrequent. We report about three cases successfully treated with heparin. A review of the literature allows identifying three factors acting in the etiopathogenesis of such thrombosis: alteration of blood composition, blood stasis and injuries to the vascular walls. The diagnosis is confirmed by ultrasonography and abdominal CT, and echo-Doppler will play a more important role in the future. The treatment of mesenterico-portal thrombosis is mainly medical, with surgery being indicated only in case of intestinal necrosis. An anticoagulant or platelet-suppressive treatment and the ligation of the splenic vein as close as possible to its junction with the mesenteric vein may be proposed as preventive measures.

Hematologic Diseases↗
PubMed1991

Pancreatic islet cell carcinoma with hypercalcemia: complete remission 5 years after surgical excision and chemotherapy.

A 45-yr-old man who presented with hypercalcemia was found to have an abdominal mass that was a pancreatic islet cell carcinoma. Although clinical features were suggestive of primary hyperparathyroidism, his parathyroid hormone level was not elevated. The patient underwent a radical resection of the pancreatic neoplasm which was situated in the tail of the gland. After surgery, the serum calcium fell within the normal range, suggesting that the tumor was responsible for production of a parathyroid hormone-like substance. Because of malignant histologic features of the lesion, a chemotherapeutic regimen including 5-fluorouracil and streptozotocin was indicated. Five years later, the tumor has remained in total remission.

Adenoma, Islet Cell↗
PubMed1989

[Stenosing and perforated ulcers of the small intestine related to potassium chloride in enteric-coated tablets. Apropos of 11 cases].

The enteric coated KCl tablet formulation generates complications that affect selectively the small intestine. A novel 1 g KCl tablet preparation proved to be accountable for the development of a specific type of intestinal disease. 11 cases of stenotic ulcers of the proximal ileum have been treated at the Clinique chirurgicale "C" (CHRU, Nancy) since January 1986, 9 of them presenting with perforations. These 11 patients required potassium replacement, which was being supplied by the same tablet formula. A study of these 11 cases focusing on the patients history and clinical characteristics was carried out, that included both macroscopic and microscopic examinations of the lesions. Arterial and venous networks were visualized by X-ray in two surgical tissue specimens, respectively, following injection of contrast material. The authors were thus able to bring forth evidence of the clinical uniqueness (prodromal pain reminiscent of König's syndrome and peritonitis characterized by asthenia); to identify the main risk factor (i.e., reduced bowel movement); as well as describe the basic lesion (pylorus-like stenosis), and propound a novel theory concerning the etiology and the pathology of this condition. The observation of the aforementioned cases initiated a nation-wide, post-marketing pharmacological survey, which resulted, as did a similar investigation which had been carried out in the States, in the discontinuation of any treatment by this type of galenic form of the product.

Adult↗
PubMed1987

[Peritoneal actinomycosis. A rare disease. 2 cases].

We report two cases of peritoneal actinomycosis, a rare localization of an uncommon disease (27% of the 212 cases previously published). The disease presents with tumoral symptoms. It is exceptionally diagnosed before surgery which usually consists of a safety excision. The true nature of the tumour is revealed by pathological examination, and its consequence is an antibiotic treatment. In the 2 cases reported here the patients had an old, uncontrolled intra-uterine device which might have been the portal of entry of the infection.

Actinomycosis↗
PubMed1986

[Surgical treatment of villous tumors of the rectum and sigmoid. Apropos of 79 cases].

The authors analyse a series of 79 villous tumors of the rectum and sigmoid. These tumors are observed more often in men at an average age of 65. They distinguish benign tumors (44 cases), premalignant (21 cases) and malignant tumors (14 cases). The histology of the whole piece has a greater value than a preoperative biopsy. There are many clinical symptoms and the forms with electrolyte depletion are not rare (6 cases). Tumors with wide implantation need a surgical treatment. It will be conservative in benign cases, but the excision will be wide in cases of invasive malignancy. The indication are based upon the localisation of the tumor on the rectum. Mortality of wide excision is quite important (10) because of the bad general feature of the patients. Recurrences must be detected early by regular endoscopic follow-up.

Adult↗
PubMed1986

[Emergency surgery in colonic obstructions. Retrospective study of 70 cases].

70 patients with complete colonic obstruction requiring emergency surgery were treated at the "Clinique Chirurgicale C" between 1977 and 1984. Carcinoma was the cause of obstruction in 65 cases. Obstruction was situated on the right colon 8 times, on the splenic flexure 13 times, and on the left colon 49 times. In emergency obstruction of the right colon was treated by right hemicolectomy in 6 cases with 0 death. Obstruction of the splenic flexure was treated in 10 cases by simple loop colostomy, twice by resection with ileo-sigmoid anastomosis, 1 by resection without anastomosis with 5 deaths. Obstruction of the left colon was treated by simple loop colostomy in 46 cases. Of the 34 patients who survived after loop colostomy, 26 were reoperated and in 23 cases a resection could be performed with 2 deaths and the colostomy could be closed in a third stage in 20 cases without death. 5 years survival of curative resection was 57%. It is concluded that primary resection is the best treatment for obstruction of the right colon and of the splenic flexure. But three stage resection seems to be a good procedure for obstruction of the left colon with low mortality, low morbidity and good 5 year survival.

Adult↗
PubMed1985

[Rectal metastasis of breast cancer. Apropos of 2 cases].

2 cases of rectal metastatic breast carcinoma were treated by an abdomino-perineal resection. The rectal involvement is quite uncommon, and only 6 others cases treated with surgery have been described in the international literature. We think that only radical surgery can give a good palliation.

Adenocarcinoma↗