[Desmoid fibroma of the abdominal wall].
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Biomedical subjects
Publications and source records attributed to J Videau.
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One case of ureterohydronephrosis fistulized into an urinoma in a patient with an aortobifemoral prosthesis is reported. The analysis of the literature shows that this kind of expression is exceptional, both because of the location of the urinoma and of its tuberculous origin.
The superficial peroneal nerve was taken from 12 arteriosclerotic non-diabetic patients just after amputation of a leg. Preparations of teased fibers were performed in 8 cases. Specimens were studied by light and electron microscopy in all cases. Histograms of myelinated fibers in transverse semi-thin sections showed that depletion of myelinated fibers varied from case to case, with no selective vulnerability in either the large or the small diameter group. There was a dramatic loss of myelinated fibers in only one case. No real nerve infarct was observed. In most cases, regions of Wallerian-like degeneration were prevalent; however, myelino-axonal changes were severe only in a few cases. Axons with organelle aggregates were seen in some cases. Figures of segmental demyelination were not numerous in this series. Unmyelinated fibers were also damaged, and the degree of involvement differed from case to case. Pathological changes observed in this study confirm the relative resistance of peripheral nerve to ischemia.
A case of post-traumatic hepaticoportal arteriovenous fistula between common hepatic artery and portal vein is reported. This localization of the lesion is exceptional, and early, marked clinical manifestations allow rapid diagnosis and treatment before the development of a portal hypertension.
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From January 1986 to June 1994, 252 cases of closed liver trauma were treated in an emergency setting. Non surgical conservative management, after a complete imaging work-up including CT scan in all cases, was applied in 142 cases (56.3%) with no hemodynamic complication. The spontaneous outcome in these cases was quite favourable in 131 (92.2%); all lesions had disappeared in 4 to 36 weeks. Complications were observed in only 6 cases: 2 intrahepatic abscesses managed with percutaneous drainage were not further complicated, 1 biliari fistula required surgical exploration, 1 intrahepatic bilioma was drained percutaneously, 1 disinsertion of the gallbladder was treated by laparoscopy and 1 operation for bleeding was required 48 hours after the trauma in 1 case. No deaths could be directly imputed to the liver trauma, 5 patients died from neurological causes. Non-surgical conservative treatment combined with strict prolonged surveillance is a reliable management option for patients with closed liver trauma.