Biomedical subjects
Publications and source records attributed to K Hosni.
Carney's triad is a very unusual syndrome, associating three different tumours on the same patient, a young woman generally: a gastric leiomyoblastoma, a pulmonary chondroma and an extra-adrenal paraganglioma. The authors report through the literature review and a new case of Carney's syndrome associating gastric leiomyoblastoma and extra-adrenal paragangliomas, the different diagnostic and therapeutic criterias.
INTRODUCTION: Surgical treatment of achalasia of lower oesophageal sphincter is Heller's myotomy, usually associated with a fundoplication due to an high risk of postoperative gastro-oesophageal reflux. The value of this fundoplication is discussed. The aim of this study was to evaluate retrospectively the results of Heller's myotomy without fundoplication but performed according to a precise technique preventing postoperative reflux. PATIENTS AND METHODS: Between 1975 and 1999, 123 patients underwent Heller's myotomy without systematic fundoplication. Diagnosis of achalasia was performed clinically and confirmed by investigations: baryum meal, fibroscopy and manometry. Myotomy was performed through an abdominal approach in 117 (95%) patients. Dissection preserved fixity of abdominal oesophagus in all cases, particularly its posterior meso. Myotomy was performed on abdominal oesophagus but not below the cardia. Posterior fundoplication was associated in 2 patients. RESULTS: One patient (0,8%) died from massive aspiration. Morbidity (1,6%) consisted in one peritonitis and one postoperative occlusion. At follow-up (mean = 5 years; range: 1-20), functional results were satisfying (excellent and good) in 112 (92%) patients. Seven patients (6%) developed postoperative reflux, including one who need surgical treatment. Dysphagia persisted in 3 patients (2%) who had to be reoperated. CONCLUSION: Results of this series show that systematic fundoplication is not necessary in Heller's myotomy for achalasia of lower oesophageal sphincter.
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The study aim was to report an adenocarcinoma of the anal glands revealed by an anal abscess in a 64-year-old man. Malignant transformation of an anal fistula is discussed in the genesis of this disease. Clinical symptoms are not specific. Abdomino-perineal resection of the rectum is the usual surgical treatment and adjuvant radiation therapy didn't prove its efficiency.
Inflammatory pseudotumor of the spleen is a very rare benign lesion of unknown etiology. Splenectomy is recommended to obtain histological diagnosis and to eliminate a malignant tumor.
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Thirty-two duodenal ulcer perforations were treated by suture and supraselective vagotomy. Perioperative mortality was nil. The recurrence rate was 6.2% against 17% after elective supraselective vagotomy performed by the same surgeons during the same period. Results of this technique for treatment of perforated duodenal ulcer are compared with those of 28 simple sutures and 32 truncal vagotomies.
Authors report 121 cases of post bulbary ulcers between 1969 and 1987. They precise the frequency of complications in this localisations of the ulcerous disease: Hemorrhage: 38% Stenosis: 39.6% Peritonitis through perforation: 9.09% Anatomical reports of the post bulbary area explain the anatomo-pathological aspects made by the above mentioned complications added the biliodigestive fistula and perforations blocked of a surgical treatment. Considering these elements, the authors show the difficulty of a surgical treatment. They suggest choosing the most simple intervention: Treating the ulcer without approaching the ulceron area; namely; making truncal vagotomy and duodenoplasty, that of Finney being the most adapted in case of haemorrhage. On case of a stenosis, with gastric ditension, exclusion gastrectomy is the adequate intervention. The results are good, except two deaths that occurred by cataclysmic ulcerous haemorrhage.
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BACKGROUND: Leiomyoma is a benign tumor rarely occurring in the esophagus. Only 1% of esophageal tumors are leiomyomas. CASE REPORT: A 70-year-old man underwent surgery for an asymptomatic tumor of the thoracic esophagus. The tumor was enucleated via right thoracotomy and histology confirmed the diagnosis of leiomyoma. Outcome was favorable. DISCUSSION: Leiomyomas of the esophagus generally develop from the muscularis and exceptionally from the muscularis mucosae, producing a parietal tumor or a pediculated endoluminal tumor respectively. Surgery is indicated for all cases, with the possible exception of asymptomatic leiomyoma. Encleation can be achieved by videothoracoscopy. Resection of the esophagus can be discussed if enucleation is impossible for giant tumors, or ring tumors at the esogastric junction, or if the mucosae wound cannot be repaired. Endoscopic resection is indicated for pediculated leiomyoma. Malignant transformation is exceptional but an association between esophageal myomatosis and carcinoma of the esophagus is possible. Certain authors thus advocate resection for all cases, even small asymptomatic leiomyomas.