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Biomedical subjects

J Lescut

Publications and source records attributed to J Lescut.

At least 19 recordsLinked to original sources

[Pancreatic-portal fistula. A rare complication of chronic pancreatitis].

We report a 40-year-old patient with complication of chronic pancreatitis as a pancreatico-portal fistula. The patient had subcutaneous nodular fat necrosis of the lower limbs resembling Weber-Christian syndrome, and amylasic ascitis. The diagnosis was established with retrograde endoscopic cholangio-pancreatography which found three pancreatic pseudocysts and a communication with the portal venous system. A portal thrombosis with cavernum was studied with color echo-Doppler and arteriography. The echo-endoscopy was performed for the first time in this complication and its significance estimated. The evolution was quickly and spontaneously favourable. That is a very rare complication of chronic pancreatitis and an expectant conservative management can be adopted.

Adult↗

[Distal splenorenal shunt without deconnection in the prevention of recurrent digestive hemorrhage in the cirrhotic patient].

The emergent treatment of gastrointestinal hemorrhage caused by the rupture of esophageal varices in cirrhotic patients is based on sclerotherapy. The prevention of frequent recurrence may be an indication of portocaval shunting. Over an 8-year period, 72 patients were operated with a distal splenorenal shunt without deconnection aimed at preventing gastrointestinal rebleeding. This was non-emergent surgery. The Child-Pugh grade was 41 A and 31 B. All patients had an angiography, which demonstrated the lack of arterioportal reflux. Operative mortality was 2.7%. Actuarial survival at 5 years was of 67%, respectively 71% for grade A and 60% for grade B. Patency of the shunt was estimated to be 90%. Persistence of hepatopetal flow on control arteriography has been established in 65% of cases. Rebleeding was observed in 10% of cases, and episodes of encephalopathy in 10% as well out of 60 studied cases, 29 presented with a chronic increase in ammoniemia (48%). Two risk factors of mortality have been demonstrated: age higher than 60 years, and relapse of ethylic intoxication, which has been observed in 40% of cases. Later hepatic transplantation has been performed in one case, without success. These results are similar to those obtained with Warren's procedure. Further development of hepatic transplantation may limit its indications.

Actuarial Analysis↗

[Colonic complications of pancreatitis. A report on 39 cases (author's transl)].

Colonic complications of pancreatitis are not infrequent occurrences, as illustrated by the fact that the authors have personally treated 39 such cases. Lesions are found in the colon at sites which correspond perfectly to diffusion of pancreatic necrotic lesions along mesenteric pathways as described by Meyers. They occur mainly in the left colic flexure (17 cases) and transverse colon (10 cases) but may affect the ascending (6 cases) and descending (4 cases) colon by diffusion of the pancreatitis into the anterior extrarenal space. These topographical characteristics, associated with the extrinsic and inflammatory nature of the lesions, produce a very specific and typical radiological syndrome which should assist diagnosis.

Adult↗

[Extension of infiltrating cancer of the stomach into the transverse colon (author's transl)].

The extension of infiltrating stomach cancer through the gastrocolic ligament into the transverse colon appears to be relatively common. The radiological appearance is characteristic, with more or less widespread, but shallow, extrinsic prints with irregular contours typical of malignant tumours. Its gastric origin is strongly suggested by its position of the superior border of the transverse colon. The authors report 6 observations in which the value of this very characteristic radiological abnormality of the colon to diagnose primary stomach cancer was confirmed. Radiological appearances are not very specific in primary stomach cancer and interpretation is often difficult; endoscopy or even biopsies are often inconclusive.

Adult↗