[Esophageal metastases from cancer of the breast. Apropos of a case].
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Biomedical subjects
Publications and source records attributed to A Belmahi.
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Rupture of hydatid cyst of the liver into the biliary tract is a severe and relatively frequent complication, and its treatment is controversial. Cysto-biliary disconnection provides an anatomical disjunction between the residual cavity and the biliary fistula. The operation consists of draining the main biliary tract, the ectocytic cavity and the fistulous tract, using a multiperforated drain which exists through a transparenchymatous channel. This technique has the advantage of avoiding the postoperative bile discharge and shortening the hospitalization time. It seems to give excellent short- and long-term results.
The authors report 203 cases of gastric cancer collected between 1974 and 1987 without prior selection. Analysis of these records provided the following information: From an epidemiological viewpoint, there was no predominance of blood group A; a certain number of gastric lesions preceded or coexisted with the cancer. From a clinical viewpoint epigastric pain and general physical deterioration were the most frequent presenting signs. Physical examination was normal in 32.5% of patients, while 34.4% presented a palpable epigastric mass. Diagnosis was confirmed by a combination of radiology (transit studies of oesophagus, stomach and duodenum) and endoscopy with multiple biopsies. These procedures were carried out in 88% and 72% of patients respectively. 87% of patients were operable and resection was possible in 50%. Subtotal gastrectomy was performed in 61% of cases where resection was possible. The overall operative mortality was 8.5% and 20% for extended total gastrectomy. Actuarial survival was only correctly evaluated in 42% of operated patients. It was estimated to be 5%.
The authors report a complicated leiomyosarcoma gastric case with hemoperitoneum. The exploratory laparotomy reveals an hemoperitoneum constituted from both gastric tumors. One was localised in the antrum and was encapsulated, the other in the cardia and had an encephaloid and necrotized core. The pathological examination of the total gastrectomy piece is consistent with a double gastric localisation of a leiomyosarcomosis. 5 years after the initial operation, the patient developed hepatic metastases. A review of literature allows the authors to make the point of this disease.
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