Computed tomography in paraprosthetic sigmoid fistula.

A patient with a paraprosthetic-sigmoid fistula following complicated aortic abdominal surgery is reported. Computed tomography confirmed the diagnosis by demonstrating inflammatory tissue around the left limb of the prosthesis in close contact with the sigmoid.

Changes in small intestinal epithelial expression of MHC class II antigen after terminal ileal resection for Crohn's disease.

Aphthous lesions in the neoterminal ileum from patients operated for Crohn's disease are an early sign of recurrence that can be identified during ileocolonoscopy. The origin of these lesions was studied in nine patients treated by terminal ileal resection and right hemicolectomy for complicated Crohn's disease. During surgery the neoterminal ileum was turned inside out, the mucosa was carefully inspected and two large mucosal biopsies were obtained.

[Treatment of intestinal atresia].

Thirteen cases of intestinal atresia are described: 9 jejunal and 4 ileal. The duration of pregnancy was significantly shorter and the birthweight significantly lower in jejunal than in ileal atresia. The proximal intestine was strongly dilated in 8/9 cases with jejunal atresia.

The use of biochemical parameters for a qualitative and quantitative assessment of ischemic damage to the small-intestinal mucosa.

Lactate dehydrogenase has been measured in the small-intestinal mucosa in order to assess its value as a marker for the effects of ischemia and of reperfusion. The decrease in specific activity of the enzyme illustrates the deleterious effect of reperfusion on the quality of the remaining epithelial cells. However, this parameter fails to detect the loss of epithelial cells, which is the major event during ischemia as well as during reperfusion.

[Benign stomach tumors: histology, diagnosis and surgical experience].

Benign neoplasms of the stomach lead to atypical symptoms. Radiological and endoscopic investigations are always recommended. Our surgical experience with 11 epithelial and 26 mesenchymal benign neoplasms is discussed.

[Partial gastrectomy for benign stomach ulcer: early and late results].

106 patients had a partial gastrectomy for a benign gastric ulcer. 63 of them got a long-term follow-up. The mean follow-up is 127 months.

Subtotal resection of the head of the pancreas combined with ductal obliteration of the distal pancreas in chronic pancreatitis.

Subtotal resection of the head of the pancreas combined with duct obliteration of the distal pancreas by prolamine was performed in 12 selected patients who had chronic alcohol-induced pancreatitis with most destruction in the proximal pancreas. The main indication for operation was intractable pain. There was no postoperative mortality but morbidity was high when no pancreaticojejunostomy was constructed.

Hepatic echinococcosis ruptured into the biliary tract. Clinical, radiological and therapeutic features during five episodes of spontaneous biliary rupture in three patients with hepatic hydatidosis.

Three patients are described with hepatic involvement by Echinococcus granulosus, complicated by spontaneous rupture into the biliary tract. Clinical features consisted of upper abdominal pain, jaundice, fever, anorexia, and vomiting. Hepatomegaly and marked epigastric tenderness were consistently observed.

Transection of the pancreas demonstrated by ultrasound and computed tomography.

The early occurrence of peritoneal signs and hyperamylasemia in a 14-year-old boy, who had fallen off his horse, urged us to perform a sonographic and computed tomographic study of the upper abdomen. Both examinations showed a complete pancreatic rupture. Distal pancreatectomy led to a rapid and uneventful recovery.

Biochemical and functional aspects of recovery of mammalian systems from deep sub-zero temperatures.

The viability of isolated mammalian systems is, apart from possible morphological changes, essentially conditioned by the biochemical modifications from normal physiological conditions to an artificial environment where blood supply is interrupted leading to ischaemia and where the temperature is lowered. In order to survive freezing and thawing, mammalian systems have to be protected by cryoprotectants, which apart from some inherent toxicity, may also interact with vital metabolic mechanisms (Conover, 1969, 1975: Fahy, 1986: Fahy et al. 1984: Jacobs & Herschler, 1986: Karow, 1982: Penninckx et al.

Preservation of taenia coli by freezing and storage at -196 degrees C.

Some damaging effects that occur during cryopreservation by freezing to -196 degrees C have been evaluated in rabbit taenia coli by analyzing the proportional recovery of acetylcholine- and histamine-induced maximal contractions. Dimethyl sulfoxide (Me2SO) 10 v/v% was used as the cryoprotectant; it reversibly abolishes spontaneous contractility even after incubation at 37 degrees C during 2 hr. Programmed freezing at 0.

Internal sphincter-saving in imperforate anus with or without fistula. A manometric study.

Manometric assessment was performed in 54 infants with congenital ano-rectal anomalies including those with a blindly ending rectum (6 cases) or with an ectopic bowel outlet either in the perineum (25 cases), vulva (8 cases), vagina (8 cases), urethra (5 cases) or bladder (2 cases). Infants with an externally accessible orifice were investigated preoperatively whereas those with an internal orifice or no orifice could only be evaluated after surgical correction. In all operated cases presented, the ectopic rectal opening was preserved together with its surrounding smooth musculature.

The cellular composition of granulomas in mesenteric lymph nodes from patients with Crohn's disease.

The immunohistochemical findings in granulomatous lymphadenitis in patients with Crohn's disease are presented and compared with conventional light microscopic findings. The cellular composition of the granulomas in mesenteric lymph nodes was examined with a broad panel of monoclonal and polyclonal antibodies directed to B-cells, T-cells, monocytes/macrophages, dendritic reticulum cells, HLA-DR antigens and the transferrin receptor. The centre of the granulomas contains OKIa+, OKM1+, OKT9+, DRC-, To5- epithelioid cells and giant cells and OKT3+ lymphocytes.

[Objective evaluation of anorectal function in fecal incontinence].

Evaluation of anorectal function in faecal incontinence. In cases presenting faecal incontinence, an etiological diagnosis should be based on history, clinical examination, anuscopy and rectoscopy. This diagnosis should be confirmed or contradicted by the results of objective investigations, especially manometry, myography and radiology.

The healing of single- and double-row stapled circular anastomoses.

The healing of anastomoses performed by single- or double-row circular stapling instruments is analyzed in the dog colon. Mucosal healing is better in single-row stapled anastomoses. Apposition of the outer intestinal layers is superior in double-row stapled anastomoses.

Primary gastric actinomycosis: a case report and review of the literature.

A case of primary gastric actinomycosis presenting as a bleeding gastric tumor is reported. The diagnosis of this infection of the stomach is difficult and may often be established only by histological examination. If the disease is recognized, the prognosis is good because antibiotic treatment is very effective.

Erythrocyte swelling after rapid dilution of cryoprotectants and its prevention.

These in vitro studies on canine red blood cells confirm that cell swelling occurs after rapid dilution of Me2SO and glycerol. Cells loaded with a penetrating cryoprotectant in a medium with low Na+, high K+ composition present significantly less swelling after rapid dilution of the cryoprotectant than cells exposed to an electrolyte medium characterized by high Na+, low K+ composition. The osmotic cell stress during rapid dilution of Me2SO can be completely counteracted by the simultaneous use of the nonpenetrating sorbitol during exposure and loading.