[Peroperative alternating omentoportography. Study of the portal system in pancreatic operations].
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Biomedical subjects
Publications and source records attributed to P Warter.
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The ingestion of a caustic acid resulted in retractile fibrosis of 2/3 of the stomach with a secondary duodenal fistula. The antro-pyloro-duodenal circuit was re-established at around the 3rd after ingestion. However, the duodenal fistula caused the formation of encysted pelvic abscesses which were difficult to drain and satisfactorily treat. The clinical course stretched over a period of 4 years.
Present-day techniques used in the surgical treatment of bony metastases of the limbs are described in relation to a series of 116 cases. Emphasis is laid on the possibilities of osteosynthesis or preventive arthroplasty.
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We feel that arteriography occupies at the present time an indispensable and irreplaceable role in the pre-therapeutic assessment of a soft tissue tumour of the extremities. It obviously cannot provide a definite diagnosis in all cases with regard to the benign or malignant nature of the lesion. However careful analysis of the various features of the images obtained, leading to a radiological classification of the tumour into one of three groups (LEVIN, WATSON and BALTAXE), makes possible, in groups I and III, to predict the nature with a high probability of accuracy. Only in type II (35% of our cases) is it impossible to make such a deduction. The value of arteriography is not limited to diagnosis. It also provides information on the extent and arterial supply of the tumour which are essential to the surgeon and which cannot be supplied by any other investigation.
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Two types of non-functioning supernumerary kidney pelvis are defined by analyzing 12 cases discovered in adult life. Those of congenital origin from glomerular aplasia, sometimes associated with a ureterocele or an ectopic anastomosis, and those due to an acquired lesion such as lithiasis, vesico-ureteral reflux, or secondary infection of a pocket of fluid. Radiological diagnosis is made by IVU with descending cystography and films taken during micturition. Cystoscopy and possibly retrograde ureteropyelography are essential in order to confirm the diagnosis.
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The authors describe two cases of secreting paragangliomas of the organ of Zuckerkandl, beinging the number of known cases to 78. They underline the interest of arteriographic and phlebographic explorations which define more accurately the origin and spread of these tumours.