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Biomedical subjects

C Veyrac

Publications and source records attributed to C Veyrac.

At least 37 records · Page 2Linked to original sources

[Fibrous epithelial polyps of the pyelo-ureteral junction in children. Presentation of 3 cases and review of the literature (33 cases)].

Primary ureteral tumors are rare and benign ones constitute only a small portion. Of the benign neoplasms, fibro epithelial polyps are probably the most common and could be considered to be an exceedingly rare cause of Hydronephrosis in children. The exact etiology of benign ureteral polyps is not certain but it is likely that they have a congenital one. They are mesodermal in origin and consist of a thick fibrous stalk covered by a layer of normal transitional epithelium. They are more commonly found in boys (80.6%), who present usually with abdominal pains or renal colics. Fibro-epithelial polyps often rise in the proximal ureter and renal pelvis, especially at the left side (69.4%). Radiographic signs are those of a non typical uretero-pelvic Junction obstruction. IVP and retrograde ureterogram usually demonstrate a long, thin, filiform, lucent filling defect within the ureteral lumen with moderate hydronephrosis. Appropriate treatment of these benign tumors is local excision with or without segmental resection. Prognosis should be considered as excellent without a report of recurrence. A review of the literature revealed 33 cases of ureteral polyps in children. We report here 3 additional cases of obstructing fibro epithelial polyps, observed in boys aged respectively 4, 8 and 9 years.

Child↗

[Role of cerebral echography in the diagnosis of aneurysms of the vein of Galen].

Cerebral ultrasound imaging by a transfontanelle approach is now a common investigation during the first year of life. This exploratory procedure is non-invasive, non-irradiating, requires no sedation and can be carried out at the infant's bedside. In addition, the classical apparatus can be completed by deep Doppler allowing deep cerebral vessels to be studied. Three cases are reported of aneurysm of Galen's ampulla detected by ultrasound imaging during the neonatal period. Images demonstrated the presence of an abnormal fluid mass in the region of Galen's ampulla, confirmed as of vascular origin by Doppler, and allowed assessment of degree of subjacent ventricular dilatation and possible secondary ischemic lesions. In massive neonatal forms this exploration may be sufficient since prognosis is poor, but in lesions of moderate size CT scan and angiographic examinations and perhaps MR imaging are required. This technique allows detection of this malformation in the fetus and could therefore influence therapy.

Cerebral Veins↗

[Congenital anomalies of the pyeloureteral junction in children. Multicenter study of 985 anomalies in 883 children].

The authors report a survey of the French Group of Visceral Pediatric Surgery, concerning 985 congenital anomalies of the pyeloureteric junction in 883 children. 67.3% of them are boys. This article stresses the recent improvements in prenatal ultrasonography and diagnosis which is now able to individualize a homogeneous group of asymptomatic children ready to be repaired in the early post-natal period. Early reconstruction is associated with the greatest degree of recovery of renal function. In children, the average age is 4 years 9 months at diagnosis. In 43.6% clinical symptoms suggest an infectious problem. Pain is noted in 35.5% and an abdominal mass is discovered in 13.3%. Excretory urography (IVP), ultrasonography and cystography are still the main investigations to be done in all cases. But it is now necessary to use modern isotopic technics such as DMSA and diuretic DTPA to quantify obstruction with accuracy and follow long-term evolution after treatment. Treatment is surgical and conservative in 81.4%. Almost all of the uretero-pyeloplasties are performed according to the dismembered technic usually with temporary nephrostomy drainage. Renal reduction is reserved only for the redundant and decompensated renal pelvis. Morbidity is low (2.5%) and good results can be expected in about 95% of cases.

Adolescent↗

[Acute intestinal invagination in infants and children, critical evaluation of the diagnostic and therapeutic strategy. Apropos of a series of 163 cases].

This study concerns a homogenous series of 163 cases of intussusceptions in children, seen in the Visceral Pediatric Surgical Unit of Montpellier from 1974 to 1985. The authors differentiate and compare two periods with regard to the year 1980: the first one (P1 = 64 cases) during which, surgery was always the rule;the current one (P2 = 99 cases) where non operative treatment is the modality of choice under precise conditions. Synthetic analysis and comparison of the different therapeutic groups which have been distinguished in every period lead to the following data. 14% of intussusceptions are directly operated whatever the period or the modality of management probably because this group represents the absolute contra-indications of a barium enema--It concerns children with a long duration of the disease, obstructive or peritonitis signs and late diagnosis--Laparotomy is mandatory and finds a high percentage of leading points and ileo-ileal forms. Intestinal resection was necessary in 59.5% of cases. Because of this and a poor general condition, morbidity was high and Hospital stay was long. 56.4% of intussusceptions are operated after failure of barium enema reduction. This hydrostatic irreducibility is probably explained by the prevalence of ileo-colic forms (53.3%) in this group. A shorter duration of the disease (less than 2 days in 43.1%) and a strong majority of idiopathic intussusception (90.5%) are surely responsible of a high percentage (80%) of successful manual reduction without the need of a resection.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

[Total colonic form of Hirschsprung disease. Apropos of 6 cases].

6 patients with total colonic aganglionosis without small bowel involvement (HCT) have been observed during a 13-years period. From this material and a review of literature, the authors stress the diagnostic and therapeutic particularities of HCT, which justify a separate analysis and a comparative study with the more typical forms of Hirschsprung's diseases. The percent of HCT out of all types of Hirschsprung's disease is 7.9%. Male to female ratio is 2:1 and familial occurrence is much higher (15 to 20%) than that seen in the classical form of Hirschsprung's diseases. A diagnosis of HCT is more difficult because of lack of specificity in clinical picture, radiologic findings and manometric evaluation. However, age at time of revelation is the neonatal period in 83% and enterocolitis is present in 25% with a higher incidence than in shorter types of Hirschsprung's disease. Therefore in HCT, laparotomy with appendicectomy and open frozen biopsies is always required for correct diagnosis. Ileostomy is mandatory. It must be done early and adequate in situation and technic. This kind of diversion has its own morbidity and mortality with a higher rate than that observed after colostomy. Definitive operation must be ideally performed at age 2. The principal of preserving and utilizing a segment of colon in a side-to-side anastomosis to the ganglionated small-bowel, followed by a pull-through ileoproctostomy has been established as a reasonable treatment for HCT since Martin's first description. 5 cases underwent a Martin repair and 1 a total colectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Cecum↗

[Ultrasonography before surgical operation of retroperitoneal malignant tumors in childhood (author's transl)].

Abdominal tumors in childhood are diagnosed almost always by palpation only, the retroperitoneal localization of these are confirmed by I.V.P. The new gray scale ultrasound machine seem to be very useful in the staging of the masses before the surgical operation. For the correct appreciation of the sensibility of gray-scale ultrasound, 6 Wilm's tumors, 6 neuroblastoma and 1 malignant retroperitoneal fibroma were reviewed. These children were echographied just before the surgical procedure and the surgeon's reports were compared with ultrasonics findings. If the sensibility is good to give measurement of the masse and to establish the situation of the tumor toward the midline of the abdominal cavity, the visualisation of the great vessels was not so obvious. However these hepatic structures were well established in all cases. The renal vein was never seen. At the end of this report it's possible to describe differential echographic findings between Wilm's tumor and neuroblastoma. --A Wilm's tumor is a mass well limited in periphery, confused with the kidney and with a frequent sonolucent rim sign. --A Neuroblastoma is a very irregular tumor well separated of the kidney without sonolucent area in its limit. U.S. made after an I.V.P. is in all cases very useful to surgeons. The two methods with their additional findings make almost always arteriography without interest.

Adolescent↗