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Biomedical subjects

F Saegesser

Publications and source records attributed to F Saegesser.

At least 55 records · Page 3Linked to original sources
PubMed1981

The acute abdomen. Part II: Acute abdomen arising from vascular disorders in the elderly.

The frequency of the "acute abdomen" has increased with the ageing of the population. In this chapter, we have examined syndromes of primary vascular origin, caused by vascular dysfunction, such as alterations in the vascular walls or haemodynamic disorders. We have left aside secondary vascular problems such as strangulation, obstruction or compression of vessels by tumours, which are easier to treat and diagnose and have a better prognosis. The symptoms of acute ischaemia caused by intrinsic vascular deficiency are not specific and clinical tests are untrustworthy. Despite progress in our knowledge of splanchnic haemodynamics, in radiology, vascular surgery and endoscopy, the prognosis remains poor. In view of the cataclysmic nature of the haemorrhage or the damage to the intestinal walls which evolves swiftly towards gangrenous necrosis, very rapid diagnosis of any of these various syndromes is essential if the patient is to be saved.

Abdomen, Acute↗
PubMed1980

[Ischemic disorders of the large intestinal wall. Ischemic colitis and rectitis secondary to intrinsic vascular disorders].

Ischaemic diseases of the large intestinal wall is a characteristic syndrome caused by vascular insufficiency of varying degrees. The ischaemia results from haemodynamic disturbances and often arises in spite of the patency of the vessels. The mucosa of the intestine is the tissue layer that is most vulnerable to ischaemia. Ischaemia of the colon occurs in the presence of a microbial flora that is often highly pathogenic, and hence the lesions rapidly become infected. For this reason the inflammatory features of the disease tend to conceal its vascular origin and ischaemic colitis has often been confused with other infectious, inflammatory, ulcero-haemorrhagic disorders of the large intestine. Although the syndrome may occur in any patient, it is much more common in elderly subjects with a history of arteriesclerosis and cardiac disease. Two main varieties can be identified, depending on the extent of the vascular insufficiency. In the first, the lesion may heal spontaneously or evolve towards fibrous strictures of the colonic wall; in the second, gangrenous necrosis of the colon or rectum may develope, the clinical picture of which has more in common with an "acute abdomen' than with ulcerative disease of the colon.

Colitis↗
PubMed1980

[Gastric lymphomas and pseudolymphomas].

We report 30 cases of non-Hodgkin's gastric lymphomas (according to the Rappaport classification): 1 nodular lymphocytic lymphoma well differentiated, 7 diffuse lymphocytic lymphomas poorly differentiated, 2 diffuse mixed cellularity lymphomas, 20 diffuse histiocytic lymphomas and 4 pseudolymphomas, over a period of 21 years at the CHUV, in Lausanne (1958-1979). There are 56% of advanced stages (IIIE and IVE) according to Ann Arbor. Survival to 5 years is of 27%. The mean survival of patients who died from their lymphomas is of 5 months only. Lymph node invasion worsens considerably the prognosis (75% of survival to 5 years for stage IE against 25% for stage IIE). This phenomenon is particular to non-ganglionary lymphomas. We do not observe good remission for the diffuse histiocytic forms at an advanced stage, remission being characteristic of the ganglionary lymphomas only. Treatment is poorly codified. Surgery along seems possible for the localised forms (IE): triple therapy (surgery, radiotherapy and chemotherapy) is necessary for advanced stages and histological unfavorable forms.

Adult↗
PubMed1980

[Carcinoid tumors, carcinoid syndromes and related tumors (104 cases)].

One hundred and four consecutive cases of carcinoid among 194 APUD-omas (cerebral and gynecological tumours expected) are presented. Localization is as follows: bronchopulmonary (21%), duodenum (5,5%), small intestine (19%), Meckel's diverticulum (5,5%), appendix (39%), colorectal (5,5%), other (4,5%). Average age at diagnosis is very different for each localization of carcinoid tumour, as is prognosis: in our material, 33% of cases had an infiltrative tumour, 17% had lymph nodes metastases and 16% hepatic metastases. All 15 patients with carcinoidosis died but their survival varied considerably in length (from a few weeks to 21 years after the beginning of carcinoidosis). In addition, 3 patients presented with the Zollinger-Ellison syndrome, 2 of them having an atypical or probable form of the MEN I syndrome.

Adult↗
PubMed1980

[Gardner syndrome: apropos of 3 families and 7 cases].

Gardner's syndrome, an hereditary affection of the different blastoderm layers, is rarely recognised, even though it is seen in 8-16% of cases of colorectal polyposis. The authors present 7 cases of Gardner's syndrome within 3 families: 4 female and 3 male. Six of the patients belonged to 2 families, of which several members suffered from familial polyposis; the seventh case was an isolated case of Gardner's syndrome, without a family history of polyposis. Because of the high risk of malignancy in the presence of polyps, the treatment of Gardner's syndrome is identical to that of familial polyposis, 4 patients underwent total colectomy, 2 a simple polypectomy and 1 refused all treatment or monitoring. From these patients, one of the polyps excised at the level of the rectum was found to be undergoing malignant transformation. The extra-colic manifestations of this condition precede the polyposis within the gut; they attract attention and thus permit an early diagnosis.

Abnormalities, Multiple↗
PubMed1980

[Urogenital complications of Crohn's disease].

Crohn's disease of the small and large intestine may involve the urinary and genital tract at different sites and in various ways. This paper focuses on the frequency of urogenital complications, their importance in aggravating the heavy morbidity of the disease. They are rarely fatal.

Adolescent↗
PubMed1980

[Pulmonary granuloma, pseudolymphoma and lymphoma].

We are presenting 10 patients with tumors of the lungs - granulomas or lymphomas - among more than one thousand patients suffering from lung cancer. Apart from the granulomas with its obvious inflammation characteristics, it seems that the distinction between pseudolymphomas and malignant lymphomas is possible through histological examinations but contrary to their clinical evolution. Two patients with s-called pseudolymphomas have shown recurrent bilateral recidivism. As shown in all medical literature, the good prognosis of pulmonary lymphomas makes the distinction between pseudolymphomas and lymphomas futile. Nonetheless, it should be noted that clinical symptoms in markedly malignant cases can appear after several symptom free years. None of our patient has died from their pulmonary condition. Only thoracic exploration and surgical ablation of the lesion permit a correct diagnosis and a satisfactory therapeutic approach. The surgical ablation of the lesion must be economical, because of frequent recurrence, sometimes bilateral. Both patients with so-called pseudolymphomas and the one with malignant lymphoma showed bilateral recurrences successfully treated by radiotherapy, with 10--15 years survival rate.

Diagnosis, Differential↗
PubMed1979

[Intralobal pulmonary sequestration and tuberculosis superinfection].

Among 16 pulmonary sequestrations observed in 23 years, 3 were associated with pulmonary tuberculosis. A detailed report is given on a 37-year-old man who was found by serendipity to have a right lower sequestration after 6 years treatment for tuberculosis; middle and upper lobe function had already been lost. Two and half years after pneumonectomy, the patient is in good health. Discussion centers on the diagnosis and potential complications of pulmonary sequestrations.

Adult↗