Biomedical subjects

C Debray

Publications and source records attributed to C Debray.

At least 271 records · Page 15Linked to original sources

PubMedDate not supplied

[Haematologic disorders in Crohn's disease (author's transl)].

Anemia is the most commonly haematologic disorder observed in Crohn's disease. Secondary megaloblastic anemia related to a nutritional deficiency of vitamin B 12 and/or folic acid is a rare condition as well as auto-immune haemolytic anemia. Iron lack microcytic hypochromic anemia is far more frequent. It is probably due to several causes as microscopic or macroscopic haemorrhages, inflammatory syndrome, disturbance of iron absorption. Hyperleucocytis, hypereosinophilia, hypoprothrombinemia related to the inflammatory syndrome and/or lesions of the bowels are frequently observed in such patients. Anyhow, heamatologic disorders seem markedly correlated with the activity of the disease and should be useful in the follow up patients with Crohn's disease.

Anemia↗

PubMedDate not supplied

[Medical mangement of Crohn's disease (author's transl)].

Medical management of Crohn's disease is above all symptomatic. According to the severeness of the case, treatment varies and may be simple (regimen, antidiarrheic agents and sulfamid drugs) or more sophisticated (continous parenteral alimentation). Sulfamids and antibiotics have a definite although temporary action. Pathogenic medication includes: 1) steroid therapy who is active, but its effects are not long stand; 2) immunosuppressors who allow for the reduction of steroid therapy dosages; 3) immunostimulants as proposed by Geffroy. Among those presently studied are Calmette-Guérin vaccine, either given orally or by scarification, and two anti-parasitic drugs, metronidazole and levamisole. Short term results are good but they worsen with time. The main problem is to know when to discuss surgery. As need be, resection although mutilating, should be timely indicated.

Adrenal Cortex Hormones↗

PubMedDate not supplied

[Surgical treatment of Crohn disease of the colon. (38 cases) (author's transl)].

From 1959 to december 1972 thirty-eight patients out of sixty having Crohn disease of the colon alone or with ileal and/or rectal involvement were operated upon. We had four post-operative deaths and one a long time after the intervention, but in relation with the initial Crohn disease. These thirty-eight patients had sixty-seven operations. Only fifty-five per cent of the operated on patients did not have any complications. Twenty-three patients had recurrence of the disease, seven of them were re-operated for this first recurrence, two of them for a second recurrence and one of these two last patients had a third recurrence. That makes twenty-seven recurrences out of forty-three resections. Among these twenty-seven recurrences, in at least seventeen cases, resection was not large enough or was not radical. Three quarters of the recurrences appear during the first year. The more exposed interventions to recurrences are left hemi-colectomies (two out of two) and total colectomies with ileo-rectal anastomosis (six out of eight). The ones that give less recurrences are total colo-protectomies or subtotal colectomies (one recurrence out of nine). Indications for the different types of interventions are analysed. Management of the rectum in Crohn disease of the colon is difficult. Procedures applied for toxic megacolon are equally very critical.

Adolescent↗

PubMedDate not supplied

[Rupture of an aneurysm of the splenic artery into the pancreas, a rare cause of gastrointestinal bleeding (author's transl)].

In a 73 year old man, repeated gastrointestinal haemorrhages first attributed to peptic oesophagitis, recurred despite anti-reflux surgery. Upper endoscopy being negative, arteriography was performed which revealed the presence of a fissured aneurysm of the splenic artery. This was successfully treated by left splenopancreatectomy. A communication between the aneurysm and wirsung's duct was found in the operative specimen. This a very rare cause of gastrointestinal bleeding. The diagnosis can be made only by arteriography.

Aged↗

PubMedDate not supplied