Extracorporeal lung support for tracheoesophageal fistula surgical repair with free flap.

Tracheoesophageal fistula results in persistent leakage of saliva into the trachea, prevents oral feeding, and predisposes to aspiration pneumonia. Large fistula closure may require a free flap to cover the defect. When the defect involves the tracheal area between the neck and the mediastinum, a tubeless field for optimal exposure can be advantageous.

Incidence and Risk Factors of Coagulation Profile Derangement After Liver Surgery: Implications for the Use of Epidural Analgesia-A Retrospective Cohort Study.

Background: Hepatic surgery is a major abdominal surgery. Epidural analgesia may decrease the incidence of postoperative morbidities. Hemostatic disorders frequently occur after hepatic resection.

[Acute coronary syndrome following a 100 µg carbetocin injection during an emergency Cesarean delivery].

Purpose: Postpartum hemorrhage affects 5% of parturients. Its prevention relies mainly on the administration of oxytocin derivatives. Carbetocin is a newly available analogue of oxytocin but has a considerable incidence of side effects.

Contribution of routine joint aspiration to the diagnosis of infection before hip revision surgery.

Objectives: To define the sensitivity and specificity of routine preoperative hip aspiration for diagnosing hip prosthesis infection (HPI) and to separately analyze subgroups with and without a clinical suspicion of HPI before aspiration.

Methods: From June 1994 to June 1997, all patients scheduled for hip revision surgery underwent aspiration of the hip under image intensifier guidance. Microbiological results were compared between these preoperative specimens and the intraoperative specimens.

Pelvic cancers: staging of 139 cases with lymphography and fine-needle aspiration biopsy.

One hundred thirty-nine patients with pelvic cancers (101 bladder carcinomas, 27 prostatic carcinomas, and 11 testicular tumors) considered for radical surgery were studied with lymphography and percutaneous fine-needle aspiration (FNA) biopsy, and the results were correlated with lymphadenectomy. Adequate material for FNA was obtained in 97%, 88%, and 100% of the bladder, prostatic, and testicular tumors, respectively. For bladder carcinoma, the global accuracy was 58% for lymphography and 93% for FNA; the high false-negative rate for lymphography (48%) was lowered to 25% with FNA, providing that the obturator nodes were punctured.

[Multiple primary intraductal tumors of Wirsung's duct: demonstration of a relation between benign and malignant tumors].

A case of multiple villous and, more rarely, tubulovillous adenomas of the main pancreatic duct, associated with a diffuse infiltrating adenocarcinoma of the pancreas in which evidence for a link between these lesions is supported by histopathologic features, is reported in a 53 year old patient. Clinical presentation included abdominal pain, weight loss and chronic diarrhea with steatorrhea related to pancreatic insufficiency. Retrograde endoscopic pancreatography showed a complete stenosis of the main pancreatic duct located 3 mm beyond the ampulla of Vater.

[The intrathoracic rib. A study in x-ray computed tomography].

CT scan imaging of an intrathoracic rib demonstrated a cartilaginous component beyond the distal extremity of the bony structure.

[Value of cytopuncture associated with microbiopsy in solid masses in the pancreas. Preliminary study].

Efficacy of fine needle puncture and microbiopsy technics was compared in 19 patients with a solid pancreatic mass. Results showed sensitivity and global accuracy of 71 and 72% respectively for cytology, 92 and 82% for microbiopsy and 100 and 94% for their combined use. Global accuracy and negative predictive values reached 100% when repeat samples were collected because of insufficient material.

[Contribution of radiology in the study of ileal reservoirs anastomosed to the anal canal].

Confection of an ileal reservoir anastomosed to anal canal is a seductive issue after total coloproctectomy. In this prospective study, early complications, mainly anastomotic fistulae, were effectively detected by routine enemas with water soluble media. These complications affected 14% of patients.

[Splenic abscess. A new diagnostic and therapeutic approach. Apropos of 7 cases].

Anomalies in seven patients with splenic abscess were invariably observed on ultrasound imaging despite absent or misleading clinical symptomatology splenomegaly was detected in only 3 cases. The abscess was multiple in 6 cases with perisplenic extension in 2 patients. Splenectomy was performed in only 2 cases.

[Diffuse multiple villous adenoma of Wirsung's canal. Neoplastic transformation. Value of x-ray computed tomography].

Results of CT scan imaging in a patient with diffuse, multiple villous adenomas of Wirsung's canal showed intracanalar budding. The diffuse nature of the villous lesion of Wirsung's canal and the juxtaposition of pure adenomatous lesions, dysplastic lesions and malignant papillomas make this an exceptional if not unique observation in the literature.

[Suprascapular and axillary subcutaneous emphysema after perforation of a pharyngolaryngeal cancer].

A case is reported of a laryngeal cancer recurrence that had invaded and then eroded the pharynx. The fistula produced was the cause of a thrombophlebitis of upper limb, and subcutaneous emphysema limited to the right shoulder region due to radiosclerosis of soft tissues of neck.

[Extradural hematoma after the surgical treatment of kyphosis].

Two patients developed paraplegia during the course of surgical reduction and fixation of kyphosis: one of congenital origin and the other related to Marfan's disease. Myelography with contrast showed an extramedullary hematoma, treated surgically.

[Intrathoracic and retroperitoneal plasmacytomas in multiple IgA myeloma].

A case of multiple myeloma of bone with retroperitoneal extension is reported and results of ultrasound and computed tomography imaging in this affection discussed. The tumoral mass can be evaluated with precision due to the reliability of CT scan imaging in the diagnosis of bony lesions and a positive diagnosis made and follow up reviews of changes in extra-osseous myelomatous masses conducted by combined ultrasound and CT scan imaging.

[Value of hormonal markers in the detection and therapeutic surveillance of malignant adrenal cortical carcinoma].

The value of hormonal markers in the diagnosis and early and late surveillance of adrenocortical carcinoma was assessed in a series of 10 cases and from a review of the literature. Although hormonal investigation with measurement of precursors, performed whenever there is the least clinical suspicion of ACC, is of certain diagnostic value, the possibilities of postoperative controls have not yet been fully exploited: the results are difficult to interpret because of possible interference due to the secretion of the controlateral adrenal; plasma renin activity is rarely assessed in the late postoperative period. A general strategy of investigation and surveillance is proposed.

[Hypertension in malignant tumors of the adrenal cortex. A review of clinical, biological and hormonal features].

Hypertension may be a prominent and sometimes the dominant expression of tumours of the adrenal cortex as demonstrated in a personal series of 9 cases and in comparable series in the literature. It is therefore important, despite their relatively low incidence, to recognise adrenal cortical tumours as the cause of hypertension. The present study was undertaken to show that this diagnosis is relatively easy.