[Acute haemocholecystitis due to carcinoma of the gallbladder (author's transl)].
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Biomedical subjects
Publications and source records attributed to M Mercadier.
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A statistical study aimed at the determination of any possible differences between calcifying and non-calcifying chronic pancreatitis. It would seem that whilst there are differences from a histopathological and biological standpoint, these differences disappear completely as far as postoperative course is concerned. Curiously enough, the long term prognosis was the same regardless of the type of pancreatitis.
In this study of 500 cases of bleeding from the upper digestive tract, the importance of emergency fibre endoscopy is emphasised. It is in fact the only way to demonstrate acute gastro-duodenal lesions which are very frequent, especially during post-operative intensive care. As far as treatment is concerned, the interest of gastric lavage with ice-cold drinks is emphasised in hemostasis. As far as surgery is concerned, the indications are now well known depending on the rate of transfusion during the first few hours and the etiology. In chronic duodenal ulcers, vagotomy, pyloroplasty and suture of the ulcer have always given good results. This is also the case with acute ulcers. On the other hand, in gastric ulcers, gastrectomy remains the treatment of choice. When bleeding is due to oesophageal varices, surgery is only indicated in exceptional cases.
In 32 patients with carcinoma involving the bifurcation of the hepatic ducts 17 intrahepatic cholangiojejunostomies and 3 intrahepatic gastrotomies were performed. The post-operative mortality rate is high (35%), the median survival time is 9 months. These results suggest that resection should by attempted when possible or dilatation used rather than by-pass of the tumor.
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Two unusual cases of ruptured acute amebic liver abcess are presented one with inferior vena caval compression. Surgical drainage was followed by the development of colonic complications (haemorrhage and perforation) although the patients were under specific therapy. After a new surgical operation both cases were cured. The relation with amebiasis is discussed. The possibility of such an association must always be kept in mind. The value of immunofluorescence test in the diagnosis is emphasised.
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