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B Descottes

Publications and source records attributed to B Descottes.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Heterotopic pancreas. Three cases].

The authors report three cases of heterotopic pancreas discovered surgically in three young men. The heterotopy was located in the biliary tract in one case revealed by choledochal stenosis (case 1), in the stomach discovered at laparotomy for abdominal trauma (case 2) and in the first part of the duodenum discovered during hepatic resection for adenoma (case 3). Management consisted of Whipple's operation in the first case, tumor resection in the second and antroduodenectomy in the last case. Histological examination revealed no malignant transformation. Results were excellent with follow-up 2-years to 4 years. The authors recommend resection with histological examination for all case of heterotopic pancreas discovered at surgery.

Abdominal Injuries↗
PubMed1997

Anatomic and MRI study of the subtalar ligamentous support.

The diagnosis of subtalar instability remains difficult both clinically and radiographically. The authors present an anatomic and MRI study of the subtalar ligamentous support. The anatomic study has consisted in dissections and sections of cryoconserved hindfeet (15 cases) which precises the organisation of ligamentous bundles in the lateral (sinus tarsi) and central (canalis tarsi) subtalar compartments, mainly represented by the trilayered inferior extensor retinaculum, the cervical talo-calcaneal ligament and the interosseous talo-calcaneal ligament. MRI study (1.5 tesla) of anatomic specimens was performed according to defined types of sections: sagittal, coronal, coronal oblique, axial transverse. The correlations of anatomic and MRI sections allowed a precise interpretation of the subtalar ligamentous support as anatomically described. A complementary clinical MRI study was performed which allowed the validation of "the inversion test": this test optimizes the visualization of the different ligamentous structures. Relative to the difficulties of conventional imaging procedures, MRI appears of clinical relevance in the diagnosis of subtalar instabilities. This technique allows direct visualization of ligaments (or their rupture) and therefore a better evaluation of subtalar involvement in ankle sprain. This paper present a functional concept in MRI articular ligamentous restraints concern.

Humans↗
PubMed1997

[Limits of laparoscopic surgery of adrenal glands. Apropos of 17 cases and a review of the literature].

OBJECTIVES: To review own cases of laparoscopic adrenalectomy in order to better ascertain limits therapeutic management and indications, compared with the literature data. PATIENTS-METHODS: Medical files of 15 patients after 17 laparoscopic adrenalectomies in the Dupuytren hospital of Limoges from February 1994 to November 1996, were analyzed 10 women and 5 men mean aged 59.4 years (22-77) were operated. Transperitoneal laparoscopic adrenal resection indications were: Conn adenoma (3), Cushing discase (2 bilateral resection), adrenal incidentaloma (9) and adrenal metastasis (1). RESULTS: Mean (range) of adrenal tumor size was 4 cm (0.8-7.5 cm). Operating times mean (range) was: 3 hours 40 minutes (1 h 50-6 h). Mean (range) of hospital stay was 3.4 day (3-6), marquedly reduced than open traditional adrenal surgery. Neither complication nor mortality per- or post-operative were present. But the laparoscopic operation required conversion to an open adrenal resection in 3 cases (18%). COMMENTS: Laparoscopic adrenalectomy offer real advantages: effectiveness and safety with a reduced time hospital discharge. Indications and adrenal size limits need to be precised on largest studies.

Adrenal Gland Diseases↗
PubMed1996

[Primary adenocarcinoma of the duodenum. Study of three cases and review of the literature].

The authors report three cases of primary adenocarcinoma, two concerning the duodenum and the third concerning the duodenojejunal junction. These rare tumours are characterized by polymorphic and non specific clinical signs. Diagnosis is suspected by upper gastrointestinal fibroscopy and barium swallow, and confirmed by biopsies. Prognosis varies according to histological differentiation and lymph node extension. Whipples operation is the sole curative procedure in the absence of local lymph node involvement. Cases of extensive invasion are managed by bilio-digestive by-pass.

Adenocarcinoma↗
PubMed1996

[The lateral retromalleolar groove: a radio-anatomic study].

The anatomy of the malleolar peroneal groove is presented. The results are based on a coupled osteological and CTscan study of 20 samples of fibulae. The average distal fibular torsion was 64 degrees. The peroneal groove was oriented posteriorly (mean value: 78 degrees). Three types of morphological variations were found: concave, flat, convex (the convex shaped groove was the most frequent one: 70%). The average width of the groove was 9 mm. These morphometric results were compared to "clinical" ones performed on patients with a peroneal tendons dislocation syndrome: CTscan study showed an osseous dysplasia concerning the groove depth (flat or convex) and/or a torsional insufficiency. Hypothesis of a bone dysplasia in peroneal dislocation syndrome is discussed.

Fibula↗
PubMed1992

Anatomic basis of tracheobronchial reconstruction by intercostal flap.

A feasibility study was carried out to standardise the use of the intercostal muscle flap (ICF) for reconstruction of the posterior wall of the trachea and bronchi. The program consisted of two stages. Morphologically, in anatomic specimens, intercostal muscle flaps were dissected that could be used whatever the morphotype of the subject. Ten human cadavers were dissected after a right thoracotomy in the 6th right intercostal space, providing flaps 12 to 18 cm long and 1.5 to 3 cm wide. Experimentally, studies were made on 7 dogs of the functional and anatomopathologic aspects of the reconstruction at the 20th postoperative day. The results showed impermeability and rapid healing at endoscopy on the 10th postoperative day in every case as well as regeneration of ciliated epithelium in 6 of the 7 cases. The ICF may therefore be considered for losses of tracheobronchial substance, whether accidental, spontaneous (fistulae) or deliberate (surgery for malignant or benign lesions).

Animals↗
PubMed1992

Prospective evaluation of ultrasonic surgical dissectors in hepatic resection: a cooperative multicenter study.

Blood loss is the major cause of postoperative mortality and morbidity associated with hepatic resection. A prospective multicenter study was conducted to determine if ultrasonic dissectors (USD) were useful in hepatic resection and could reduce this hemorrhagic risk. Forty-seven hepatic resections were performed in 42 consecutive patients during a two month period in 11 public, surgical centers. Twenty-one patients had primary or secondary malignancies, six had benign tumors, two had biliary cysts, one had cholangiocarcinoma, one had Caroli's disease, and 11 had hydatid cysts of the liver. Two different USD devices were evaluated (CUSA System-Lasersonics and NIIC-DX 101 T). The hepatic resections tested included a wide range of procedures. Each surgeon had the possibility of choosing between the USD and his own usual technique for each operative step and according to local conditions. The average volume of blood infused, irrespective of the underlying pathology or the procedure performed, was 1.0 L (range 0-4.8 L). Fourteen patients required no transfusions. No operative or immediate postoperative deaths were recorded. Five major complications, all unrelated to the use of the USD, developed in three patients. Access to intra and extraparenchymal arterial and venous tributaries and particularly the control of the hepatic veins were facilitated by USD. While transection of hepatic parenchyma was neither easier nor faster than with conventional techniques, it was found to be less hemorrhagic. Overall appraisal was expressed on an analog scale; the USD was found to be helpful or very helpful in 75 percent of all resections. With regard to the pathology being treated, total or partial excision of hydatid cysts was greatly enhanced by the use of the USD while this benefit was not found for wedge resections of other hepatic lesions. With regard to user friendliness and maintenance, the NIIC-DX 101 T device was preferred. We conclude that the USD facilitates formal hepatic resections. Converging opinions emerging from various surgical centers reinforce this conclusion.

Adult↗
PubMed1991

[Direct re-instillation through endotracheal intubation tubes during enteral nutrition for short bowel syndrome].

Case report of a 65-year-old man, operated on for small bowel infarction. Only the initial 40 cm of the jejunum, and the last 10 cm of the ileum were vital and could be kept. The ileo-caecal valve and the colon were not resected. Two stomas were carried out: a left-sided jejunostomy, and a right-sided ileostomy. Enteral nutrition was attempted, but jejunal outflow increased. It was therefore decided to attempt re-instillation of jejunal juices directly to the ileum using two 33 CH endotracheal tubes connected with soft chest drain tubing. A bag was placed over the jejunal tube to collect any leakage. Semi-elemental enteral nutrition could then be successfully carried out, and parenteral feeding stopped. With this simple appliance, the patient was able to lead as normal a life as possible. After 42 days of such feeding, the patient had only lost 2 kg in body weight, and intestinal continuity was re-established.

Aged↗
PubMed1991

[Gazeous necrosis of the liver due to hepatic artery thrombosis after liver transplantation].

An emergency liver transplantation was performed in a 22 year-old female for fulminant hepatitis. The donor had had splenectomy with portal vein thrombosis which was diagnosed and removed during portoscopy. Nineteen days later, abdominal pain with shock and hepatic failure occurred. X-rays showed pneumoperitoneum and aeric images in the liver area. Laparotomy disclosed massive liver necrosis with gaz under the Glisson's capsula. The hepatic artery was thrombosed. In spite of emergency retransplantation, the patient died 8 days later, due to systemic aspergillosis. Thrombosis of hepatic artery was particular by the importance of gaz-forming infection, and emphasizes the role of rejection. The discovery of portal thrombosis allows to outline the precautions necessary in case of splenectomized donors. The severeness of aspergillosis is underscored.

Adult↗
PubMed1991

[Diaphragm of inferior vena cava associated with Budd-Chiari syndrome. Contribution of ultrasonography and color Doppler echocardiography].

We report the case of a young man presenting clinical features of portal hypertension of unknown origin. The ultrasonographic examination showed suprahepatic blockage signs leading to the diagnosis of Budd-Chiari syndrome caused by incomplete diaphragm of the inferior vena cava. The color Doppler examination suggested caval obstruction, showing an abrupt shift from a laminar to a bosterous flux. Secondly cavograms and surgery later confirmed the diagnosis.

Adult↗
PubMed1991

[Totally implantable venous access sites. Results of a series of 101 cases].

The authors report their results of the use of 101 totally implanted venous access systems for chemotherapy in 92 patients. They stress the high incidence (19.8%) of complications: thrombosis 6.8% and 6.9% linked to the material. The correct complication rate must be decreased by strict attention paid to the surgical procedure, use and greater education of the nursing staff. The value of this material is to give greater comfort to patients and to assess its widespread use for intensive long-term chemotherapy.

Adult↗