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Biomedical subjects

D Valleix

Publications and source records attributed to D Valleix.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Pancreatic neuroendocrine tumors and von Hippel-Lindau disease].

Pancreatic neuroendocrine tumors are rare in von Hippel-Lindau disease, most often asymptomatic, nonfunctioning, non secreting, and benign. We report a case of low grade malignant pancreatic, secreting and asymptomatic neuroendocrine tumors, occurring in a 27 year old woman in the setting von Hippel-Lindau disease with recurrent pheochromocytoma, retinal and medullary hemangioblastomas, paraganglioma of the carotid body and ovarian cystadenoma. Neuroendocrine pancreatic tumors of von Hippel-Lindau disease are often constituted by clear cells, in the contrary of other neuroendocrine tumors of the pancreas. Occurrence of a pancreatic neuroendocrine tumor, especially in association with pheochromocytoma, may be misdiagnosed with a type 2 multiple endocrine neoplasia syndrom instead of von Hippel-Lindau disease.

Adrenal Gland Neoplasms↗
PubMed2000

[Bilobar Thyroid Agenesis].

A case of a 27-year-old female patient presenting with bilateral agenesis of the thyroid gland and a benign euthyroid adenoma of the isthmus and the pyramidal lobe is reported. The patient had for several years been followed for a cystic nodule that was presumed to have developed from the left thyroid lobe, having recently increased in size. Scintigraphic and echographic studies evoked the absence of right lobe. Direct examination at cervicotomy found hypoplasia of the two lobes. This report highlights the similarity of this rare anomaly to widely known hemiagenesis.

Adult↗
PubMed1999

[Ruptured hepatocarcinoma. Report of 22 cases].

STUDY AIM: Spontaneous rupture of hepatocellular carcinoma (HCC) causing massive hemoperitoneum is a critical and life threatening complication. The study aim was to report a retrospective series of 22 cases observed in the same centre. PATIENTS AND METHODS: From 1978 to 1998, 22 patients (18 males and four females, mean age: 63 years, range: 18-83) were treated for ruptured H.C.C involving a cirrhotic liver in 17 cases and a normal liver in five cases. In 14 cases, the diagnosis of acute hemoperitoneum indicated an immediate laparotomy. The site of rupture was predominant in the left lobe (eight cases). The surgical treatment was: left lobectomy (n = 7), right hepatectomy (n = 2), excision (n = 4), hepatic artery ligation (n = 5), direct hemostasis (n = 4). RESULTS: Postoperative mortality was 45.4%. Among the 12 survivors, nine died within a delay of 6 to 29 months. Three patients were still alive at the time of this study at 32, 40 and 66 months. CONCLUSION: Acute rupture of HCC requires emergency procedures with a high risk of mortality. Curative operation with hepatic resection is the most effective procedure but is not often feasible because of the spreading of the tumor or/and the cirrhosis. The ligation of hepatic artery seems to be an alternative procedure to obtain an immediate hemostasis. Fissuration allows performance of complementary explorations and possibly preoperative arterial embolization with better immediate results.

Adolescent↗
PubMed1998

The recurrent laryngeal nerve (RLN): application to transhiatal oesophagectomy.

To emphasize the risks of recurrent laryngeal nerve lesions during transhiatal oesophagectomy an anatomical study of the course of the recurrent laryngeal nerve (RLN) was performed. Twenty RLN were dissected in their thoracic portion. This work showed the constancy of the low origin of the nerve in the adult under the aortic arch, and its course in the tracheal angle. It confirmed the close connections of the nerve with the posterior mediastinal viscera. Lastly, it displayed oesophageal nerve branches arising from the RLN and a few anastomoses between them and the tracheal nerve branches. This anatomical disposition resulted into the difficulty of transhiatal oesophaphagectomies and the risk of injury of the recurrent laryngeal nerve. The possibility of nerve lesions can explain the respiratory complications of this surgical approach.

Adult↗
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↗
PubMed1993

[Isolated inflammatory syndrome: think of benign tumors of the liver].

The authors report seven cases of benign tumors of the liver revealed by elevated acute phase reactants. They show that these elevated acute phase reactants are not linked with a particular histological diagnosis, the presence of tumor necrosis and that they disappear with the chirurgical cure of the tumor.

Acute-Phase Proteins↗
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↗
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↗