Intravenous nitroglycerin for prevention of pancreatitis after therapeutic endoscopic retrograde cholangiography: a randomized, double-blind, placebo-controlled multicenter trial.

Background And Study Aims: Several studies have suggested that nitroglycerin promotes pancreatic drainage and thereby helps to prevent pancreatitis occurring after endoscopic retrograde cholangiography (ERC). We performed a multicenter, double-blind, randomized, placebo-controlled trial to evaluate the efficacy of intravenous nitroglycerin for preventing acute pancreatitis in moderate- to high-risk patients undergoing ERC.

Patients And Methods: The patients underwent therapeutic ERC for gallstone removal, bile duct stenosis, or sphincter of Oddi dysfunction (SOD).

[Alveolar echinococcosis in the French province of Ardennes: isolated case or new focus?].

The first three autochthonous cases of alveolar echinococcosis were diagnosed in the Ardennes area (France). This is the most occidental localization of this disease in Northern Europe. The authors discuss these cases with an epidemiological regard.

[Burgeoning form of cancer of the superior biliary bifurcation Nosological, diagnostic and therapeutic aspects. Apropos of a case].

The authors report a case of fungating cholangiocarcinoma of the porta hepatis, revealed by jaundice in a 73-year-old cholecystectomized female. The diagnosis of obstruction of the hepatic duct junction suspected by ultrasonography and computed tomography was confirmed intraoperatively. Disobstruction was followed by laterolateral choledocoduodenostomy.

[A new case of collagenous colitis associated with rheumatoid polyarthritis].

The authors describe a case with concomittant chronic polyarthritis and collagenous colitis. The sub-epithelial band-like collagenous deposit may be the result of fibroblastic production with autoimmune stimulation.

[A case of acute cardiac insufficiency caused by 5-fluorouracil].

The authors report a case of acute cardiac failure linked to 5 fluoro-uracil. The toxicity seen most commonly involves ischemia. The pathophysiological mechanisms are discussed as well as the role played by pharmacokinetic characteristics in the occurrence of adverse reactions.

[Cancer at confluence of the superior bile ducts with proliferating form. Nosologic, diagnostic and therapeutic aspects. Apropos of a case].

The authors report a case of fungating cholangiocarcinoma of the porta hepatis, revealed by jaundice in a 73-year- old cholecystectomized female. The diagnosis of obstruction of the hepatic duct junction suspected by ultrasonography and computed tomography was confirmed intraoperatively. Disobstruction was followed by laterolateral choledocoduodenostomy.

[Mesenteric carcinoid tumor presenting as an intra-abdominal abscess].

The authors describe a case of mesentery primitive carcinoid tumor presenting as an abdominal abscess. The clinical findings and the physiopathological mechanisms are discussed.

[Association of autoimmune thrombopenia with cancer of the pancreas. A case report].

The authors report a case of immune thrombopenia preceding a pancreatic cancer. The clinical and biological findings do not permit the diagnosis of para-neoplastic syndrome, but permit the hypothesis of immunological disorders associated with cancers.

[Gallstone duodenal obstruction or Bouveret's syndrome. Apropos of two cases].

Bouveret's syndrome is a rare form of Gallstone Ileus, characterized by its duodenal site after migration through a cholecysto-duodenal fistula in almost all cases. The two cases reported emphasize the interest of endoscopy in its early diagnosis. A therapeutic schema is proposed, based upon a systematic initial endoscopic extraction trial.

[Mesenteric cystic lymphangioma in children. Report of a case manifested by anemia].

A case of mesenteric cystic lymphangioma revealed by hypochromic anemia and abdominal pain, secondary to an intracystic hemorrhage is reported in a 4-year old child. Etiology, pathology, diagnosis, treatment and prognosis of mesenteric lymphangioma in children are reviewed.

[Mesenteric cystic lymphangioma in children. Apropos of a case revealed by anemia].

A case of mesenteric cystic lymphangioma revealed by hypochromic anemia and abdominal pain, secondary to an intracystic hemorrhage is reported in a 4-year old child. Etiology, pathology, diagnosis, treatment and prognosis of mesenteric lymphangioma in children are reviewed.

[Cancer of the anus arising within condylomata acuminata. Apropos of 2 cases. Review of the literature].

Two cases of squamous carcinoma of the anus developing from condylomata acuminata are reported. The general characteristics of condylomata acuminata are reviewed: viral etiology due to HPV virus, histological appearance and role in the the genesis of certain cancers. The association of condylomata acuminata and cancer of the anus is more particularly studied in a review of the literature: etiology, anatomoclinical aspects, treatment and current state of knowledge concerning the oncogenic role of HPV virus at this site.

[Study of the annual mortality statistics in a general surgical ward with digestive and vascular orientation at a general hospital center].

Quality of care has been evaluated in this study by the criterion of mortality in a Digestive and Vascular Surgery unit. The analysis over a one-year period concerned 34 dead patients among 1298 entered and 1,108 operated patients who underwent 1,248 operations. The causes of death have been studied in the 3 groups: non operated (5 patients), digestive (20 patients), vascular (9 patients), with distinction of emergency surgery.

[Congenital diverticulum of the lower choledochus. Apropos of a case with intraduodenal development].

The onset of subicterus in a patient revealed the presence of a congenital diverticulum of lower common bile duct of intraduodenal development. A part from the rarity of this lesion this case is of interest due to the complete range of ultrasound, endoscopic and CT scan imaging performed, the association of a common mesentery and the surgical technique employed. The latter comprised exeresis by transduodenal approach and a side-to-side choledocho-duodenal anastomosis through the intermediary of the diverticular sleeve.

[Hemorrhagic Meckel's diverticulum. The place of abdominal scintigraphy with technetium 99m. Apropos of a case with gastric and pancreatic heterotopia].

A 12 year old child presented with a hemorrhagic Meckel's diverticulum, gastric heterotopia without identifiable ulceration and a totally aberrant pancreas. The diagnostic value of 99m-technetium abdominal scintigraphy in patients with Meckel's diverticula and gastric heterotopia, as well as the limits of this investigation, are discussed.

[Angiodysplasia of the right colon: a frequent cause of lower digestive tract hemorrhage. Apropos of 13 cases].

13 observations of right hemorrhagic colic angiodysplasia were detected in less than 5 years: 9 times with proctorrhagia of varying amounts, 4 times with an endoscopic aetiological evaluation of iron deficiency anemia. Colonoscopy revealed lesions in 11 patients out of 13 in the form of erythematous spots of vascular hemorrhagic appearance in 5 cases. The arteriography was positive in 5 of the 7 cases where it was performed.

Colonic angiodysplasia. Clinical, endoscopic, arteriographic signs and histopathological correlations.

The main clinical, endoscopic and radiographic findings in thirty documented cases of colonic angiodysplasia or vascular ectasia are described. We emphasise the association with colonic diverticulosis and cardiovascular pathology, describe the histological changes, summarize the present physiopathological hypothesis, and consider the various therapeutic approaches.