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Biomedical subjects

M Servelle

Publications and source records attributed to M Servelle.

At least 19 recordsLinked to original sources
PubMed1991

[Lymphatic malformation and chyluria: presentation of a treated case without relapse].

Chyluria is a consequence of the aperture of one or more perirenal lymphatic vessels to the renal pelvis, and is characterized by milky urine, rich in protein, lipids, cholesterol and triglycerides. Where there is chyluria there is malformation of the chyliferous vessels of the small intestine associated to hypoplasia of Pecquet's cistern. A 22 year old patient who had had persistent chyluria since the age of 16 is presented with a test of induced hyperlipidemia typical of intestinal lymphatic malformation. Chyluria was demonstrated by lymphography by bilateral pedial approach and ascending pyelography. Following surgical ligation of the lymphatic vessels of the left kidney the chyluria remitted and the patient has had no further clinical manifestation up to the present, one year after surgery.

Adult↗
PubMed1987

Surgical treatment of lymphedema: a report on 652 cases.

We performed the world's first lymphography, and 2 years later we focused our surgical methods on total superficial lymphangiectomy for the treatment of lymphedema. In the course of 40 years, we have studied the results of this treatment for edemas of lymphatic origin. We surgically treated 600 cases of lymphedema of the lower limb, 48 of the genital organs, and four of the upper limb and have had very promising results. Indications for surgical treatment of these edemas due to lymphatic blockage include the considerable inconvenience caused by the very large size of the extremity affected with lymphorrhagia or chylorrhagia, the severe lymphangitis that occurs in the course of their development, and finally the malignant degeneration of the lymphatic vessels in 1% of the cases.

Arm↗
PubMed1985

Klippel and Trénaunay's syndrome. 768 operated cases.

Since 1945, we have operated on 786 patients with Klippel and Trénaunay's syndrome. Elongation of the impaired limb was invariably found while edema was present in 84%, varicose veins in 36%, and flat angiomata in 32%. Venography and surgical exploration have demonstrated malformation of the deep veins involving the popliteal vein in 51%; superficial femoral vein, 16%; both popliteal and superficial femoral veins; 29%; iliac veins, three per cent; and lower vena cava, one per cent. Good clinical results have been achieved following the surgical release of these deep veins in the lower limb. During childhood, when the difference in limb length is noteworthy, ligature of the popliteal vein of the shorter limb induces a compensating elongation. Klippel and Trénaunay's syndrome may be associated with lymphatic malformations, including lymphedema and malformation of the lymph vessels. Knowledge of the pathophysiology of these malformations of the deep veins enables a better understanding of the clinical manifestations of the condition, as well as the improved treatment of the serious vesical or rectal hemorrhage which occurs in one per cent of these patients.

Adolescent↗
PubMed1977

[Interventricular communication caused by nonpenetrating injury of the thorax].

Previously fatal in the majority of cases, traumatic interventricular communications are now curable by surgery. This is illustrated by the case described here of a 20 year old man. 62 other cases were found in the literature. A systolic murmur is the essential feature in diagnosis but it may be discovered some time after the accident. The demonstration of cardiomegaly has less diagnostic significance than ECG signs suggestive of an infarction. Haemodynamic studies are essential to confirm the diagnosis and to provide an accurate assessment of the lesion. The spontaneous course is serious since death results in two thirds of cases. Surgery is indicated, other than in well tolerated forms with a minimal shunt. The approach used has almost always been right cardiotomy. However, incision of the left ventricle offers better visibility of the lesions which may be masked by the papillary muscles when a right-sided approach is adopted. This was used in the present case with an excellent result since the patient was able to continue the military career for which he had opted.

Adult↗
PubMed1976

[Chyloperitoneum causing intestinal obstruction].

The two cases reported here show intestinal obstruction may occur by coagulation of lymph around the loops. They permit us to better understand the physiopathology of blockage of the lymph vessels whether congenital as in the first case or traumatic as in the second case. Traumatic rupture of the cisterns chyli is exceptional. The histological lesions observed on clamped biopsies show clearly the pathology of protein-losing enteropathy.

Adult↗
PubMed1976

Hematuria and rectal bleeding in the child with Klippel and Trenaunay syndrome.

We have operated upon 588 patients with Klippel and Trenaunay syndrome. The underlying factor is a congenital malformation of the deep veins: agenesis, atresia or compression by fibrovascular bands of the popliteal, femoral or iliac veins. Of these 588 patients, 6 children between 15 months and 4 years of age had severe rectal bleeding and hematuria. One of these children died from massive bleeding of the rectum with septicemia. Another boy was saved by rectal resection and the last one by subtotal cystectomy. The important venogram shows an absence of the anterior venous pathway (superficial femoral vein) compensated by the abnormal development of 2 venous groups, the vein of the sciatic nerve and large veins along the external aspect of the inferior limb. These 2 venous groups penetrate into the pelvis by the sciatic and gluteal notches and terminate in the internal iliac vein which becomes enormous and has a very high flow. This overflow hinders drainage of the venous collateral from the rectum, the bladder and the vagina. The retro adductor vein, prolongated by the deep femoral vein, represents an anastomosis between the sciatic nerve vein and the common femoral vein. The surgeon must try to widen this pathway.

Adolescent↗
PubMed1975

[Sclerosis of the intestinal lymphatic vessels].

Fibrosis of the intestinal lymphatic vessels, produced in one case by tuberculosis and, in the other, by appendicitis and peritonitis, caused blockage of the main lymphatic vessels causing, clinically, a protein-losing enteropathy similar to that noted in congenital lymphatic diseases of childhood. In the laboratory, there was noted a fall in serum protein, lipid and cholesterol. A fat absorption test was very abnormal showing a flat curve. During laparotomy, there was discovered on the small intestine, the same layout of lymph vessels, resembling a lace network, as that observed in congenital malformations. Intestinal lymphography showed considerable stasis of the opaque substance and absence of injection of the lymph vessels in the mesentery.

Chylous Ascites↗