[Bochdalek hernia: a rare cause of dyspnea and abdominal pain in adults].

We present here a case of a sixty year old man with a symptomatic hernia of Bochdalek. Its diagnostic was long to be established because this type of congenital diaphragmatic hernia is rare and mainly occurs in neonates. However when looking at a patient with dyspnea and lasting atypical abdominal pain, such a diagnosis has to be looked for, even if such a clinical entity is extremely rare in adults.

[Lymphangioma of the mesentery--surgical indication].

The discovery of a cystic image in the mesentery is a difficult diagnostic and therapeutic problem. We report the case of a 25-year-old female with a mesenteric lymphangioma, which was resected after careful consideration. The complications due to the expansion of this benign tumour are reviewed, and the surgical indications discussed.

Optimization of the kinetics of cooling of kidneys: a pig model.

We determined the kinetics of cooling in multiple organ procurement for the kidney in a pig model. A biometric analysis by regression enables us to define the factors which influence the rate of temperature decrease: weight of the donor, average rate of perfusion and difference of temperature between the rectal temperature and the temperature of the perfusion solution at initiation of cooling. The description of the temperature as a function of time follows an exponential model of the type T(t) = T0.

[Isolated splenic trauma in adults: value of Resciniti's CT scoring system to define the indications for surgery].

The data of 62 adult patients with isolated blunt splenic trauma were retrospectively analysed to determine the value of a CT score-system in the choice of treatment: nonoperative treatment versus surgical management. 22 patients (35%) without hemodynamic instability presenting with pain localized in the left flank were primarily managed conservatively. 3 of them subsequently required splenectomy.

[Closed trauma of the pancreas--diagnostic approach].

Objective: To review patients who presented lesions of the pancreas following blunt abdominal trauma, in order to determine which elements contributed to or on the contrary delayed the diagnosis. Construction of a diagnostic procedure which could be followed in order to maximize the rapidity and efficency of treatment.

Design: Retrospective study.

[Hepatic lesions after effective external cardiac massage--an iatrogenic complication not to be overlooked].

After external cardiac massage, 3-8% of patients present potentially dangerous liver lacerations. Here we discuss the case of a patient who presented a major haemodynamic instability following external cardiac massage and thrombolytic therapy. Falsely attributed to a cardiac complication, this was actually consecutive to a hepatic haemorrhage originating from liver lacerations caused by the cardiac massage.

[Lesions of hollow organs in closed abdominal trauma--the value of computerized tomography].

Introduction: evaluation of the clinical and radiological criteria for laparotomy in intestinal lacerations after a blunt abdominal trauma. Determination of the different radiological signs from the CT scan and the sensitivity of this examination in the diagnosis of intestinal lacerations.

Design: retrospective study.

Rubber band ligation of hemorrhoids: relapse as a function of time.

Rubber band ligation is a well established treatment of internal second-degree hemorrhoids. Up to now, the long-term results (> 5 years) of this method have not been assessed. The aim of this study was to determine the long-term success rate of rubber band ligation in patients with a first episode of second-degree hemorrhoids not responding to medical treatment (local cream with laxative).

Preoperative counts of CD4 T-lymphocytes and early postoperative infective complications in HIV-positive patients.

Objective: To assess the relationship between postoperative infective complications and the CD4 count.

Design: Retrospective and biometric study.

Setting: Two university hospitals, Switzerland.

[Value and limits of conventional mediastinoscopy in preoperative evaluation of primary bronchial cancer].

Purpose Of The Study: Retrospective evaluation of conventional mediastinoscopy in the preoperative staging of primary lung cancer.

Methods: Between 1978 and March 1997, 117 consecutive patients underwent conventional mediastinoscopy in the preoperative staging of primary lung cancer, after imaging had shown mediastinal lymph nodes larger than 1.5 cm.

[Pancreatic pseudocysts: choice of treatment?].

Pseudocysts of the pancreas may require drainage or resection during their evolution. External drainage can be considered as a treatment of first resort with low related morbidity. It also offers a means of treating patients with major contraindications for surgery.

[Splenic vein thrombosis and chronic pancreatitis: therapeutic approach].

10% of chronic pancreatitis (CP) cases are complicated by splenic vein thrombosis (SVT) which is responsible for upper digestive haemorrhages. To improve our approach to treatment we reviewed 30 cases of SVT associated with CP treated in our centre from 1985 to 1995. 14 patients were treated conservatively.

[Arthroscopic removal of intra-articular loose foreign bodies of the elbow].

Purpose Of The Study: We have retrospectively studied the results of arthroscopic removal of loose bodies in the elbow. The aim of the study was to determine if the etiology of the loose bodies could be considered as a criteria for technical difficulty and clinical prognosis.

Material: 16 patients (11 men and 5 female) had an elbow arthroscopy for loose bodies removal.

Kinetics of cellular viability in warm versus cold ischemia conditions of kidney preservation. A biometric study.

We have determined the kinetics of the cellular viability ratio (CVR), defined as the number of living cells over the total cell count, in pig kidneys using propidium iodide and fluorescein diacetate staining, as a function of time and preservation conditions. The kidneys were preserved in warm or cold ischemia in order to mimic the conditions of transplantation from non-heart-beating donors or multiple removal with optimal preservation of the graft, respectively. To determine the CVR, the cells were obtained by a fine-needle aspiration biopsy, which minimizes the damage to the graft.

Acute right iliac fossa pain in acquired immunodeficiency: a comparison between patients with and without acquired immune deficiency syndrome.

A retrospective review was performed of the clinical features present in 17 patients who were human immunodeficiency virus (HIV) positive requiring a diagnostic or therapeutic procedure for suspected appendicitis. Patients who were acquired immune deficiency syndrome (AIDS) free (n = 11) and those with AIDS (n = 6) were compared. Ten of the 11 patients who were AIDS-free had appendicitis.

[Stabilization of the distal radioulnar joint by Hui-Lindscheid ligamentoplasty. Report of 10 cases].

The surgical treatment of chronic sprain of the distal radio-ulnar joint remains a difficult problem. Some authors have proposed a radio-ulnar stabilization procedure which involves some loss of mobility of the forearm. Other, more radical authors, have suggested partial or complete resection of the ulnar head.

[Ectopic varices, a rare cause of digestive hemorrhage].

From January 1986 to September 1995, 4 patients were hospitalized in our ward for gastrointestinal bleeding from ectopic varices. The patients were all female, aged 30 to 65 years. The etiology of portal hypertension in these patients was alcoholic cirrhosis, cirrhosis in Wilson's disease and previous alveolar echinococcosis treated by right hepatectomy, complicated by post-operative portal thrombosis.

[Pruritus associated with liver disease: propofol, a new therapeutic approach?].

Pruritus is a severe and troublesome symptom in patients with cholestasis and is often difficult to treat. Propofol was recently shown to be efficient in the treatment of pruritus secondary to spinal morphine administration. In a prospective, randomized, double-blind, cross-over and placebo controlled study, 20 patients received 1 dose of propofol (15 mg) and 1 dose of Intralipid (1.