Biomedical subjects
Publications and source records attributed to F Gayral.
A case of lumbar hernia is reported here. The likelihood of the traumatic etiology of this case and the technics of parietal reparation are discussed. The risk of strangulation justify the preventive treatment.
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A case of perineal hernia of the rectum is presented; this case has been successfully treated by a fixation of the rectum to the sacrum by analogy with the treatment of the prolapsus of the rectum.
17 spontaneous bilio-digestive fistulae of lithiasic origin have been regrouped for study. 15 cases underwent operation and represent 1.3% of concomitant biliary diseases treated by surgery. The different symptomatic aspects are considered; biliary disorders have been found in 50% of the cases; concurrently, the frequent occurrence of biological cholestasis along with lithiasis of the common bile duct is emphasized. Preoperative diagnosis is usually established on discovery of aerobilia sometimes revealed only by X rays centred on the upper-right quadrant of the abdomen. These fistulae are in most cases cholecystoduodenal. The serious consequences of surgical treatment of biliary lesions and suture of the digestive tract seem to be related to age, usually advanced. Particular study is devoted to endoscopy both towards diagnosis and, in certain cases, therapeutic.
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Aneurysms of the celiac axis are rare, since only 50 cases were reported in 1976, 14 of which were operated on successfully. We report here the 15th case. This celiac aneurysm involved the origin of the splenic left gastric and common hepatic arteries. After controlling the aorta by a thoraco-phrenolaparotomy, the celiac artery was ligated at its origin, the anterior wall of the aneurysm was incised and the splenic and the left gastric arteries ligated by an obliterative endoaneurysmorrhaphy. The hepatic vascularization was restored from the gastroduodenal artery with a restorative endoaneurysmorrhaphy. The control arteriogram showed a good arterial revascularization.