[Malignant duodenal fistulae of colonic origin (clinical case)].

Duodenocolonic fistulas created by invasive cancer of the colon are rarely reported in the literature and their frequency is probably underestimated. We report 4 cases together with the problems encountered and therapeutic approaches used.

Original oblique sections of the retroperitoneum: radio-anatomic basis.

The authors present oblique sections of the retroperitoneum adapted to the morphology of each patient, which affects both the liver and the organisation of the retroperitoneum. This original method involve two incidences for studying the left and right retroperitoneum separately with vertical sectional planes. The authors postulate that the orientation of the retroperitoneal viscera depends on the degree of hepatic development, so these incidences are chosen with reference to axial sections of the portal bifurcation and the middle hepatic v.

Large inferior right hepatic vein. Clinical implications.

The right middle and inferior hepatic vv. are very frequent, indeed constant, but usually of small caliber. The presence of an extra-wide right inferior hepatic v.

[Synthetic prostheses used in surgery to repair abdominal wall defects (excluding groin hernias). Characteristics, in situ behaviour and applications].

This study is an updating on synthetic prostheses used today to repair incisional hernias, eviscerations and abdominal wall defects due to a severe infection or a parietal excision of malignant tumours. The present prostheses are the fruits of the constantly developing plastic industry. Their characteristics and types (mesh or patch), together with the materials they are made of, are studied taking this development into account.

Magnetic resonance imaging of the liver by oblique sections.

The authors have applied magnetic resonance imaging (MRI) to the anatomic study of the liver by comparing cadaveric sections with those obtained with MRI. This study deals with sections oblique in relation to a sagittal or frontal plane, whose orientation is determined from landmarks visible on transverse sections. Oblique sections were made in 10 cadavers using an original method.

Abnormal direct entry of the umbilical vein into the right atrium: antenatal detection, embryologic aspects.

Abnormal direct umbilical venous return into the right atrium was detected at obstetric ultrasonography in a 23 week fetus. This was an isolated anomaly; the growth of the fetus and size of the liver were normal, and the child was normal on examination at birth. Exclusion of the umbilico-placental circulation brought about closure of the umbilical vein.

[Conservative attitude in the treatment of closed injuries of the liver].

Progress made in surgical treatment of blunt hepatic trauma (BHT) are numerous. Some procedures are sophisticated, but the best results seem to be due to conservative trends. These conservative trends are observed on one hand during the laparotomy with limited hepatectomies, and peri-hepatic packing, on the other hand in non operative management (NOM).

Drainage of the scalp by the superficial temporal vein: surgical implications.

The arrangement of the veins of the scalp is not well-known. The drainage of the scalp by the superficial temporal v. was studied in 68 specimens dissected from unembalmed cadavers.

The cystohepatic ducts: surgical implications.

The cystohepatic ducts (CHDs) drain the entirety of a hepatic territory of variable extent into the cystic duct or gallbladder (cholecystohepatic ducts). Certain very rare patterns of the CHDs constitute anomalies but as a rule a CHD represents one of the numerous variants of division of the extrahepatic bile-ducts. Their existence is explained by the normal anatomic development of the bile-ducts.

[The repair of recurrent postoperative incisional hernias. Objectives and therapeutic indications (68 cases)].

Among 327 surgical repairs of incisional hernias done between 1974 and 1989, 68 repairs (21%) were performed because of a primary treatment failure. Failed primary attempts of cure had been unique in 71%, and multiple in 29% of cases; their procedure had been essentially suture or herniorrhaphy. Site of recurrent incisional hernia (R.

The supernumerary muscles of the leg: a report of two cases.

Two cases of supernumerary muscles of the leg reported, which were both inserted on the sides of the calcaneus. The accessory soleus m., adductor of the fore-foot, is a variation of the triceps surae which through hypertrophy on the medial side of the leg can become particularly problematic in athletes.

[Variations of division of the extrahepatic bile ducts: significance and origin, surgical implications].

As opposed to congenital anomalies, the anatomical variations, as well as the modal type, are issued from a normal morphological development. The variations of division of extra-hepatic biliary ducts are very frequent. They are clearly explained by the sequence of embryological development in man, and also by compared anatomy.

The femoral artery and flexion of the hip joint.

The behavior of the femoral a. when the hip joint passes from the position of extension to the position of flexion at 90 degrees was studied in 13 cadavers, using several methods: anatomic sections, arteriographies or vascular casts. The modifications of the direction and shape of the femoral a.

Functional anatomy of the liver of the human fetus: applications to ultrasonography.

The anatomy of the liver of the human fetus was established on the basis of cadaveric techniques, but its study has been transformed by obstetric ultrasonography. This work is based on a personal study of the normal morphology of the liver of the human fetus and on a review of the current literature, particularly with regards to vascularization. The liver is the digestive organ whose rudiments appear earliest and which develops most rapidly.

Magnetic resonance imaging of the liver by frontal (coronal) sections.

In general, frontal sections of the liver in magnetic resonance imaging are used less than sections passing through other planes of space. Frontal sections of the trunk in magnetic resonance imaging involving the liver, performed in over 80 patients for various reasons, were compared with frontal sections of the trunk made in 10 cadavers. A general schema was established of the anatomy of the liver studied in the frontal plane.

A general review of anomalies of hepatic morphology and their clinical implications.

Anomalies of hepatic morphology, as opposed to anatomical variations, are rare. Nevertheless, knowledge of such anomalies is important since they do not always remain clinically latent. Four case studies of different types of anomalies encountered in surgical practice in the adult are reported herein.

Anatomical basis of rectus abdominis myo-cutaneous flaps.

The recent development of myo-cutaneous flaps and their use in plastic and reconstructive surgery prompted the authors to have a particular interest in musculo-cutaneous flaps of the rectus abdominis. From their personal studies and from a review of the literature, they consider the anatomical bases for these flaps and the different methods proposed for their construction. Finally they indicate their vast area of application which is essentially related to the wide range over which they can act.

[Verifying the function of hepaticojejunostomies by scintigraphy of the bile ducts].

Thirty six hepatobiliary scintigraphies with 99mTc-Dimethyl IDA were performed in thirty patients with an hepaticojejunostomy one month to ten years after surgery. Twenty patients underwent surgery for biliary disease and ten for duodenal or pancreatic disease. In most cases (twenty three), the radionuclide study has been systematically performed to assess the scintigraphic pattern of a normal hepaticojejunostomy.

[The cysticohepatic duct and the subvesicular duct. Apropos of 2 types of bile ducts of different significance].

A cysticohepatic duct drains a particular region of the liver. It represents an anatomical variation of the biliary tree. On the contrary, a subvesicular duct represents an abnormality of the biliary ducts development.

[Pancreatic injuries. Report on 42 cases (author's transl)].

Between 1975 and 1980, 42 pancreatic injuries have been managed, they represented 9.5 per cent of abdominal injuries. Nine patients received penetrating trauma and thirty three patients sustained blunt trauma, the majority of them was a road accident.