Biomedical subjects
Publications and source records attributed to P Vuylsteke.
Congenital cysts of the seminal vesicles with ipsilateral renal aplasia or dysplasia are rare but have been well described in the literature. We report the first case where anal tenesmus was the only presenting symptom. Another unique feature was the combination of this anomaly with a duplication of the inferior vena cava.
A 22-year-old woman developed transient left-sided ischemic colitis with submucosal oedema and bleeding, six weeks after an uneventful right hemicolectomy for Crohn's disease. The thrombogenic properties of the contraceptive pill and the concomitant use of an ergotamine alkaloid were thought to be the cause of this complication in a patient at risk. An increase of procoagulant activity and underlying vascular injury has been described in Crohn's disease.
Cystic lesions of the adrenal gland are rare entities. Pseudocysts account for 40% of all cystic tumors of the adrenal glands, and are a consequence of hemorrhage and degeneration. Clinical signs are aspecific. On US and CT, a well defined large mass with cystic appearance is found. Thickening and irregularity of the cystic wall areas of different attenuation values within the cyst and central calcifications are due to hemorrhage. The more complex pseudocysts should be distinguished from cystic degeneration in adrenal malignancy and from cystic hypernephroma in the renal upper pole.
Desmoid tumours of the anterior abdominal wall are benign neoplasms arising from musculo-aponeurotic tissues. Desmoid tumours tend to be locally infiltrative resulting in a high local recurrence following surgical resection only. From 1980 to 1989, 10 patients with desmoid tumours of the anterior abdominal wall were treated. Two patients had only surgical resection, six patients received adjuvant radiation therapy after surgical resection and two patients had medical and/or chemotherapeutic treatment. At the time of analysis, all six patients with adjuvant radiation therapy after a microscopically incomplete resection showed no evidence of disease. Radiation therapy in adequate doses can achieve local tumour control after microscopically incomplete resection of a desmoid tumour of the anterior abdominal wall.
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The recurrence rate after highly selective vagotomy was evaluated in patients with chronic duodenal ulcer disease presenting non-refractory (64 cases) or refractory ulcers (41 cases) followed for 1 to 8 years postoperatively. Refractoriness was considered when an ulcer remained symptomatic and was not healed at endoscopy after 8 weeks (3 cases) or 12 weeks (30 cases) of appropriate treatment with cimetidine, or when it recurred during maintenance therapy and did not heal after adapted treatment (8 cases). The cumulative 5 year-recurrence rate was 28.7% in refractory ulcers, in contrast with 9.3% in non-refractory ulcers (p less than 0.05). The early and constantly increased risk of recurrences in the refractory ulcer group could not be explained by factors related to surgeon or technique, nor by differing patient characteristics, including sex, age at the first ulcer episode, duration of the preoperative ulcer disease, familial ulcer history, prior ulcer complications, use or abuse of anti-inflammatory drugs, caffeine or alcohol, smoking habits and occupational state. It is concluded that highly selective vagotomy can not be considered a surgical procedure of choice in patients with refractory duodenal ulcers as there are valuable alternatives.
The observation of a gastric pseudolymphoma is presented. Diagnostic, pathologic and therapeutic implications of this uncommon condition are discussed.
The authors report one case of primary torsion of the greater omentum. The presenting symptoms are similar to those of an acute appendicitis. Diagnosis is rarely considered before laparotomy. The presence of sero-sanguineous peritoneal fluid should lead to careful exploration of the omentum, with resection of the involved segment.
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