Biomedical subjects
Publications and source records attributed to J M Horeau.
Cytobacteriologic study of 150 gallbladder fluid samples obtained before cholecystectomy found no correlations between clinical manifestations, gross and histologic features of the gallbladder, and underlying biliary infection. The potential parts played in these discrepancies by bile, time to surgery, and use of antimicrobial agents are discussed.
We report three cases of young female patients (26, 30, 36 years) with intraperitoneal hemorrhage associated with a rupture of a liver cell adenoma. Their topography was central or with central extension. Three patients had taken oral contraceptives, for a period of 10 years, before diagnosis in two cases and for only three weeks in the remaining patient. The diagnosis of hemoperitoneum from a liver tumor was established on initial symptoms and ultra sonographic examination. Angiography and CT were the most valuable investigations. The control of hemorrhage was obtained by hepatic artery ligation (2 cases) and angiographic embolization (1 case). We observed one patient with liver adenomatosis, uncommon lesion consisting of numerous adenomas in an otherwise normal hepatic parenchyma. In emergency major hepatic resection for an adenoma, in central localization, is too a high risk procedure for a benign tumor. Control of hemorrhage should be the aim of treatment, best achieved by alternative treatment, such as hepatic artery ligation of angiographic embolization, highly effective in our experience. Resection may be delayed for a residual tumor.
We report two cases of actinomycosis of the gallbladder due to Actinomyces naeslundii. Both patients presented with acute cholecystitis. After cholecystectomy with the removal of gallstones each patient made an uneventful recovery. The literature on cholecystitis due to Actinomyces is reviewed.
Of 116 Meckel's diverticula operated upon over a period of 13 years, 35 had provoked severe disorders and 80 p. cent of the cases concerned patients under 30 years of age. Occlusions represented half of the lesions involved, perforations, hemorrhages, and diverticulitis being less frequently involved. Mucosal heterotopia was a relatively frequent finding: 13 p. cent of cases, and was often the origin of hemorrhagic accidents. Asymptomatic diverticula can be potentially pathologic, as 2 carcinoid tumors and 2 cases of gastric heterotopia were discovered during routine examinations, suggesting that prophylactic excision of apparently healthy diverticula should be performed in young subjects.
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The authors present a case of acute ischemia of one lower limb with a an uncommon etiology. The cause of embolism was an incomplete thrombosis of the abdominal aorta; this followed a blunt trauma occured three months before. Some similar cases, reported in the litterature, are resumed. This observation permits the authors to review other cases of rupture and post-traumatic thrombosis of the abdominal aorta.
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The authors report 4 recent cases of abdominal intercostal hernia and in the light of other cases in the literature, discuss the clinical presentation of this curious and rare disease. Presenting all the characteritics of an uncomplicated hernia, abdominal intercostal hernia is an easy diagnosis on a single clinical examination. Further respiratory and digestive investigations are however essential before undertaking a surgical cure of this hernia at the limit of the thorax and abdomen. Treatment is purely surgical. Instead of the classical treatment by the direct approach, where the risk of relapse is important, one should prefer the transperitoneal approach with use of an inert supple prosthesis. This method gave excellent results with a follow-up of from 1 to 3 years.
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