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Biomedical subjects

C Peillon

Publications and source records attributed to C Peillon.

86 records · Page 5Linked to original sources
PubMed1988

Rectal peptic ulceration--a rare cause of rectal bleeding. Report of a case.

Analysis of the 27 cases of heterotopic gastric mucosa reported in the literature and a new case described here elucidates the main features of this disease: 1) all but one asymptomatic case were diagnosed in infants or in adults under 26 years old; 2) although rectal bleeding occurred in 24 patients, rectal peptic ulceration was found in only 13; 3) six of the patients also had rectal duplication; and 4) 19 times the limited extension of the heterotopic gastric mucosa was compatible with a complete excision by a transanal approach.

Adolescent↗
PubMed1988

Visceral revascularization by anastomosis between the left renal and Drummond's marginal artery.

Drummond's marginal artery was revascularized by anastomosis with the left renal artery in two patients with visceral ischemia due to occlusion of the celiac and superior mesenteric arteries. In this manner, the authors avoided entering an infected abdominal cavity, interposition bypass and aortic clamping. In both cases, visceral arterial supply was improved. In one case, a left renal steal syndrome was observed. Because of possible renal involvement, indications for this technique should be carefully chosen.

Aged↗
PubMed1988

[Endoluminal angioplasty of iliac obstruction. Immediate results and cumulative patency at 2 years in 23 patients].

23 patients with obstruction of one or both main iliac arteries underwent one or more transluminal angioplasties by catheterization via the obstructed vessel. 26 iliac arteries were thus reopened. The length of obstructions varied from 1 to 10 cm. The majority of the obstructions were of recent onset whilst in 6 cases the presumed date was more than 6 months previously. In all cases potency was obtained with normal follow-up angiograms in 20 cases, and a residual though not hemodynamically significant stenosis in 6 cases. All patients were followed up by Doppler and in the majority of cases by venous digital angiography, with a follow-up at the present time of 6 months to 2 years. 2 patients underwent surgery because of reobstruction occurring 2 and 13 months after dilatation. Cumulative patency is 79% in 2 years, similar to results obtained by surgery. These results show that iliac angioplasty, a simple procedure, may avoid or delay surgery, and that it should be widely used in this precise anatomical indication.

Adult↗
PubMed1988

[Bronchial resection-anastomosis for cicatricial stenosis. Physiopathologic and therapeutic considerations].

The exploration of a stenosis of an intermediate bronchus in a 50 year-old woman showed it to be severe, limited, and non-malignant. Pre-operative angiography showed hypovascularization of the right lower and middle pulmonary lobes. A short resection of the stenosis, with termino-terminal bronchial anastomosis was performed. Post-operative evaluation showed normal bronchography and angiography. This suggests that bronchial stenosis plays a role in the hypovascularization observed before its surgical correction, the most likely hypothesis being vasoconstriction.

Anastomosis, Surgical↗
PubMed1988

[Reoperations for early thromboses of femoropopliteal and tibial artery bypass. Apropos of 50 cases].

The mechanism of thrombosis early after subinguinal bypass and outcome after revision surgery have been rarely analyzed. Results are reported of revision surgery for early thrombosis in 50 cases (10% of subinguinal bypass operations during the same period). Initial indication in the 40 men and 9 women (mean age 66.9 +/- 1.74 (SEM) years), was severe chronic or acute ischemia in 82%. The 50 thrombosed bypasses included 40 femoropopliteal, 8 femorotibial and 2 short bypasses. The bypass was by saphenous in situ (21 times), an inversed saphenous (9 times), a mixed bypass (12 times) and a prosthesis (8 times). The distal arterial bed was evaluated as good in 50% of cases. Analysis of cause of thrombosis, of the operative procedure and of the time before surgery enabled a technical cause to be determined in 31 of the 50 cases. Corrective surgery produced 16 permeable bypasses and 34 definitive thromboses complicated by 21 amputations and a 10% mortality. Improved results were related to a venous bypass (p less than 0.05), to a time before operation of less than 24 hours (p less than 0.02) and to a good distal bed. The 1 year actuarial permeability for the 50 bypass operations was 35%. Mixed bypass procedures and technical problems during surgery appear to be the principal predisposing factors of early thrombosis. In this series, the preoperative distal pressure index and intraoperative flowmetric recordings were not reliable predictive elements.

Aged↗
PubMedDate not supplied

Transluminal angioplasty of failing infrainguinal arterial by-pass grafts: initial and long-term results in 13 patients.

Thirteen stenotic infrainguinal arterial bypasses (12 venous, 1 Gore-tex graft) were treated by transluminal angioplasty, either percutaneously (10 patients) or surgically (3 patients). Eleven procedures were immediately successful (two at the proximal portions of femoropopliteal grafts, six near the distal anastomoses, and three at the distal parts of femoroinfrapopliteal grafts) and dilated stenoses are still patent with a mean duration of 24 months in all patients except 2 who died during the follow-up period. The calculated cumulative patency rate is 85% at 36 months. Two procedures were followed by immediate disruption near the distal end of an in situ saphenous bypass graft where balloon inflation was performed. These required immediate surgical repair. Dilatation of the distal ends of in situ saphenous femoropopliteal bypasses may not be as safe as in other locations.

Aged↗
PubMedDate not supplied

[Treatment of pancreatic pseudocysts by laparoscopic cystogastrostomy].

AIM: To evaluate the clinical results of laparoscopic cystogastrostomy and to determine the potential advantages of this new therapeutic option. PATIENTS AND METHODS: This study concerned 12 patients presenting with pancreatic pseudocyst and operated on by laparoscopic cystogastrostomy between 1997 and 2002. There were five men and seven women with a median age of 46 years (range: 30-72). In ten patients, the pseudocyst developed after acute pancreatitis and the median delay between the acute onset and surgery was 7 months (range: 2-24). In two patients, the pseudocyst was associated with chronic pancreatitis. All the patients had a single cyst bulging into the posterior wall of the stomach and the median cyst diameter was 9 cm (range: 5-14). RESULTS: Endoluminal gastric laparoscopy was used in six patients and intraperitoneal transgastric laparoscopy in six patients. Conversion to open surgery was required in one patient because the cyst could not be correctly localised by laparoscopy. The median size of the cystogastrostomy was 3 cm (range: 2-5). In eight patients, necrotic debris were still present within the cyst. The median operative time was 90 min (range: 60-140) and the median postoperative hospital stay was 6 days (range: 4-24). No mortality was recorded and postoperative morbidity was limited to one haematoma of the rectus sheath on a port site. One patient was readmitted on the 20th postoperative day because of cyst infection due to partial closure of the cystogastrostomy and was treated by endoscopic placement of a stent. One patient was lost for follow-up 2 months after surgery. With a median clinical and radiological follow-up of 12 months (range: 6-36), no recurrence of pancreatic pseudocyst was observed. CONCLUSIONS: In this series, laparoscopic cystogastrostomy is associated with a low postoperative morbidity and an effective permanent result. Laparoscopy has two main advantages: an excellent control of haemostasis and the creation of a wide communication with debridement of the cyst contents thus minimizing the risk of infection or recurrence of the pseudocyst.

Adult↗
PubMedDate not supplied

Arterial erosions in acute pancreatitis.

Acute pancreatitis was observed in 492 patients. Fourteen (2.8%) developed an arterial erosion revealed by a haemorrhage either in the digestive lumen, in the peritoneum or via previously placed drainage. The eroded artery was the splenic artery in six patients, a pancreatico-duodenal artery in five patients. An initial haemostasis was attempted by: a) embolization in four patients: one died; the three others had bleeding recurrence. b) splenocorporeal pancreatectomy in four patients, three had bleeding recurrence. c) arterial ligature in four patients: three had bleeding recurrence. Secondary haemostatic procedures were performed in ten patients but a durable haemostasis was achieved in only five patients: two had a pancreatic resection and three were treated by a redo-binding. It is noteworthy that durable haemostasis could not be obtained neither by embolization nor by ligature in necrotic tissues. This could explain the difference in the results of arterial erosion treatments in chronic and in acute pancreatitis. Therefore, it is suggested that haemostatic procedures should be performed away from necrotic tissues, or eventually done after their removal.

Adult↗
PubMedDate not supplied

[Surgical thoracoscopy].

Surgical thoracoscopy is performed with laparoscopic material and instrumentation and is not limited to the therapeutic applications of classical pleuroscopy such as thoracic sympathectomy or pleurectomy for pneumothorax. It is a simpler, more rapid technique which causes less tissue damage and appears to be more effective than the other transparietal techniques. It has been performed twice for sympathectomy and five times for recurrent pneumothorax with excellent results.

Humans↗
PubMedDate not supplied

[Neuroma of the common bile duct: a rare cause of jaundice].

We report a case of neuroma of the main bile duct arising twenty years after cholecystectomy. The patient, a 82-year-old woman, was admitted for jaundice. Endoscopic retrograde cholangiography showed a regular stenosis of the main bile duct. Histologic examination demonstrated neuroma. Based on the analysis of this and 15 other previously published cases, the following features of bile duct neuroma were outlined: a) variable interval between cholecystectomy and the onset of jaundice (6 months to 35 years); b) the generally complicated postoperative course, c) the various localizations on the biliary tree (cystic, main bile duct, intrahepatic bile duct) and, d) the circumstances of onset.

Adult↗