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Biomedical subjects

L Descos

Publications and source records attributed to L Descos.

At least 37 records · Page 2Linked to original sources
PubMed1991

Azathioprine induced liver disease: nodular regenerative hyperplasia of the liver and perivenous fibrosis in a patient treated for multiple sclerosis.

Azathioprine hepatotoxicity has been described mainly in renal transplant recipients. Most reported cases are related to lesions of the venous system of the liver: peliosis hepatis, veno-occlusive disease of the liver, perisinusoidal fibrosis, and nodular regenerative hyperplasia of the liver. The most common clinical manifestation of these hepatic vascular lesions is portal hypertension. We present a case of nodular regenerative hyperplasia and perivenous fibrosis in a patient receiving azathioprine for multiple sclerosis. Histological abnormalities were similar to those described in renal transplant patients, and azathioprine was the only potential hepatotoxic agent present.

Adult↗
PubMed1991

[Prospective study of a predictive scoring system for the diagnosis of appendicitis in patients with right lower quadrant pain. Long-term outcome].

The results of prospectively determined scoring system for the diagnosis of appendicitis (sex, age, duration of symptoms, contracture, hyperleucocytosis) are reported. Between 1984 and 1989, 492 patients with suspected appendicitis were examined. Among the 208 operated patients, 169 had acute appendicitis (81.25 percent). Diagnosis of the abdominal pain was established in one of 3 patients without appendicitis (105/323; non operated patients or operated patients with normal appendix). Eighty-five percent of the non operated patients and 92 percent of the patients operated on with normal appendix have been followed (mean follow-up 26 months). Ten percent of the non operated patients (24/237) have been operated on during follow up; 13.9 percent of the operated patients with normal appendix (5/36) and 22.8 percent of the non operated patients (54/237) still complained of persistent right lower quadrant pain (no significative difference). In conclusion, a clinical scoring system is of help in suspected acute appendicitis. This attitude requires the cooperation of the general practitioner and must be well explained to families of patients.

Abdominal Pain↗
PubMed1991

[Massive small bowel resection. Apropos of 27 cases].

27 patients were admitted in the Digestive intensive care unit of Croix-Rousse Hospital after a massive bowel resection (residual bowel 120 cm). The etiology was of vascular origin in 15 cases. The length of intestine was nil in 4 cases, between 20 and 50 cm in 12 cases, and between 50 and 120 cm in 11 cases. A colon resection was performed in 20 cases. For 5 patients, a "double temporary intestinal stoma" for ischemic bowel was made. A "second look laparotomy" was performed in 11 cases. The definitive intestinal continuity restauration was made in 23 cases (7 immediately, 16 later) with 3 duodenocolic anastomoses. 8 patients were able to find back a oral alimentation. 19 patients (with 4 total bowel resections) received a home parenteral nutrition. Actually, 11 are alive.

Adolescent↗
PubMed1990

Conservative treatment of low rectovaginal fistula in Crohn's disease.

A conservative operative treatment of anovaginal fistula in Crohn's disease is described. This consists of simply laying open the fistula with section of the rectovaginal septum and the portion of external sphincter superficial to the fistula. The operation may be performed in the presence of rectal involvement even during an acute exacerbation of the disease; a temporary defunctioning stoma is not required. The fistula was of the high transsphincteric type in three patients and low transsphincteric in six. All wounds healed in less than 3 months without any further surgery. At a mean follow-up of 29 months, 6 had perfect continence and 3 could control solid but not liquid stools nor flatus.

Adult↗
PubMed1990

Comparison between lactulose-mannitol test and 51Cr-labelled ethylene diamine tetra-acetate test in inflammatory bowel diseases.

A direct comparison was made between mannitol-lactulose and EDTA tests in 10 control subjects and in 9 and 19 patients suffering, respectively, from ulcerative colitis or Crohn's disease. The markers were orally administered in a random order and urinary recoveries were measured. At group level, significant differences were only observed in EDTA test results between control subjects and Crohn's disease patients. At the individual level, these tests exhibited poor sensitivity in ulcerative colitis, both in the inactive and active forms of the disease. In contrast, in patients suffering from Crohn's disease, the lactulose and EDTA recoveries and lactulose/mannitol ratios reached interesting figures, particularly in the EDTA 24-hr-test where 63% of the results were abnormal. This percentage climbed to 75% when active forms of the disease were selected. More interestingly, addition of abnormal results obtained with sugar and/or EDTA tests provided a significant increase in sensitivity with figures up to 90% in the entire group and 92% in patients with active forms of the disease. It is suggested that a) Neither the lactulose-mannitol test nor the EDTA test is useful in ulcerative colitis even in the active forms, b) in Crohn's disease, the sensitivity of the EDTA test is greater than that of the sugar test, c) a combination, in the same patient, of the EDTA and sugar tests is able to provide an interesting percentage of sensitivity.

Adult↗
PubMed1990

[Post-traumatic hemobilia caused by arteriobiliary fistula. A case report and review of the literature].

One new case of post-traumatic hematobilia due to an arteriobilary fistula is reported. This etiology is relatively rare, and its diagnosis is sometimes difficult if the three signs: pain, bleeding and jaundice are not observed. The most effective paraclinical examination still is selective arteriogrpahy, which makes the diagnosis possible, accurately locates the fistula and sometimes allows hyperselective embolization, as it did in this case. The use of embolization for the treatment of post-traumatic hematobilia due to an arteriobiliary fistula reduces operative mortality for this disease, which still has a poor prognosis.

Adult↗
PubMed1989

[IgM kappa gastric plasmacytoma].

A case of gastric plasmacytoma in a 50-year old woman was reported. Immunofluorescent and immunoperoxidase studies were performed. Polyclonal antibodies reactive with immunoglobulin chains and a panel of 14 monoclonal antibodies reactive with B and T cells, and epithelial cells were used. These studies showed that the tumor cells produced IgM Kappa molecules whereas no monotypic immunoglobulin could be detected in the serum and urine. On the other hand the tumor cells had the immunologic phenotype of plasma cells. This helps diagnosis: some lymphomas with plasmocytic differentiation could also produce a monotypic immunoglobulin. Treatment using a combination of surgery, radio and polychimiotherapy was effective, leading to complete remission.

Female↗
PubMed1988

Assessment of the lactulose-mannitol test in Crohn's disease.

The mannitol-lactulose intestinal permeability test was evaluated in 100 healthy controls and 47 patients with Crohn's disease. These patients were further separated into three subgroups of increased activity (Harvey-Bradshaw index) and in two subgroups, with elective colonic lesions and associated ileal and colonic lesions. Results were given as percentages of urinary recoveries for mannitol (M), lactulose (L), and L/M ratio. As a whole, patients with Crohn's disease have lower mean M and higher mean L and mean L/M ratios than controls. The magnitude of alterations in M, L, and L/M increased with activity. The sensitivity of the test, however, reached interesting figures (67%:L and 86%:L/M) only in subgroup III which was composed of relapsing patients. Mean M was lower in patients with associated ileal lesion but, whatever the criterion (M, L, or L/M), the test does not provide any clue for the detection of a possible infraclinical associated ileal localisation.

Adolescent↗
PubMed1988

[Terminal constipation caused by abdominopelvic asynchrony: analysis of etiological, clinical, manometric data and therapeutic results after rehabilitation by biofeedback].

The aim of this study was to describe the etiological, clinical, rectoanal manometric findings as well as the results of biofeedback therapy in a series of 65 patients (34 males, 31 females, aged between 5 and 77 years) presenting with severe primary constipation due to pelvic abdominal asynchronism. Pelvic abdominal asynchronism was statistically more frequent in males during childhood and in female patients during adult life (p less than 0.005). This study disclosed a high frequency of psychogenic factors in the onset of pelvic abdominal asynchronism (26 p. 100) as well as a high frequency of soiling (46.2 p. 100) in constipated patients. In 36.2 p. 100 of cases, pelvic abdominal asynchronism was the only abnormality. In contrast, in most of the patients, asynchronism was associated with miscellaneous rectoanal disorders: increased anal closure pressure (43.3 p. 100), decreased anal closure pressure (11.8 p. 100), impaired rectal conscious sensitivity (11.7 p. 100), and increased rectal compliance (31 p. 100). This study demonstrated that when high-fiber diet and laxatives fail, biofeedback therapy is a very interesting alternative, providing 80 p. 100 of good results in selected cases. However, we were unable to find any clinical or manometric parameters predictive of results of treatment. Follow-up studies are needed to determine long-term results of biofeedback training.

Adolescent↗