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Biomedical subjects

F Saegesser

Publications and source records attributed to F Saegesser.

At least 109 records · Page 6Linked to original sources
PubMed1977

Formation and fate of fibrin clots in the biliary tract: a clinical and experimental study.

Fibrin clots may form in the biliary tract from hemobilia or in inflammatory disease. There is a wide variation in the clinical course of such clots which is exemplified by 9 patients. They may either dissolve through fibrinolysis, get ejected into the intestine, remain and obstruct the biliary tract, or may even transform into gallstones. In order to elucidate the mechanisms involved, the behavior of blood clots in bile was studied in vitro. A model was constructed of the biliary tract and, drained by a T-tube, where human bile circulated with a flow rate resembling that in vivo. When a small amount of human blood was injected, it flowed immiscibly to the lowest level, displaced the bile, and formed a clot of pure blood. Even a minor bleeding may thus form a coagulum. This is different from the mixed clot of blood and bile that forms in experiments simulating major hemorrhage. These findings are related to clinical experience and especially to the disappearance of "retained stones" with or without the use of dissolving agents.

Biliary Tract↗
PubMed1976

[Stenosis of the small intestine of ischemic origin in the adult (segmental and transmural lesions)].

Focal ischemia of the small intestine does not always lead to necrosis and perforation, but may induce fibrous stenosis which is evidenced clinically by acute or chronic intestinal occlusion. Among 8 intestinal stenoses 5 were revealed by the presence of an intestinal occlusion whereas the others were manifested by intestinal occlusions complicated by subsequent perforation of the intestinal wall. Annulo-tubular stenoses of ischemic origin are frequently accompanied by inflammatory mesenteric adenopathies due to mucosal ulcerations in the septic environment of the intestinal lumen. Their aspect is reminiscent of Crohn's disease or annular carcinoma. Histological examination of the resected loop frequently reveals the primary oschemic origin of the stenotic lesion, characterized by the presence of macrophages loaded with hemosiderin in the thickened inflamed mucosa. The tissue alterations observed resemble those found in myocardial infarction, but the inflammatory response is more pronounced due to the septic medium. Although such stenoses are relatively rare, they should be distinguished from other lesions provoking a narrowing of the intestinal lumen, since their treatment calls for certain therapeutic precautions. In some cases, angioplastic intervention is required in order to improve perfusion of the vascular bed irrigated by the superior mesenteric artery following resection of the stenotic loop and termino-terminal anastomosis. Furthermore, during any operation requiring revascularization of the mesenteric vessels for intestinal angina, it is important to carry out a very careful examination of the state of the small intestine.

Adult↗
PubMed1975

[Malignant tumors of the anal canal and the anal margin].

81 patients with tumors of the anal canal and anal margin treated at the Cantonal Hospital, Lausanne, during the period January 1942 to June 1974 have been studied. The morbid anatomy of transitional zone and cloacogenic carcinomas, subdivided into basaloid types, is related to the anatomy and histology of the normal anal canal. The average age of the patients was 66.5 years. The incidence of canal tumors was highest in women (71% of cases), but tumors of the anal margin were most frequent in men (75% of cases). The main symptom of anal canal growths in this series of advanced cases was blood on the feces; marginal tumours were associated with anal aching. Cloacogenic carcinomas of the basaloid type have the best prognosis; this is also related to the volume and invasion rate of the tumor, which are features difficult to assess. Melanomas have the worst prognosis; leiomyomas may grow like sarcomas despite their benign histological appearance. 18 patients had inguinal metastases, and only 2 of these are alive 2 1/2 and 3 1/2 years after excision of the rectum; the volume and histological type of the tumor were unrelated to the poor rate of survival. In the light of this experience, rectal amputation is the most effective prodecure for all canal tumors and for most tumors of the margin. Radiotherapy by itself is associated with an unacceptably high risk of actinic proctitis.

Adult↗
PubMed1975

[Behcet's disease and toxic megacolon].

The gastrointestinal symptoms of Behçet's disease are ancillary manifestations of this disorder reflected principally in the form of diarrhea, abdominal pain, meteorism, nausea, and loss of appetite. If radiological changes can be detected they generally appear as dilatation of the small intestine or ulceration at different levels of the digestive tract. In our patient the intestinal symptoms started with dilation of the ileum and then toxic megacolon developed. At later follow-up examinations the radiological picture resembled Crohn's disease and ischemic colitis of the entire organ. It has been repeatedly, and wrongly, stated that there is an association between Behçet's disease and Crohn's disease or ulcerative colitis. Rather, it should be assumed that the intestinal manifestations of Behçet's disease correspond to those of Crohn's disease and ulcerative colitis without these diseases being actually present. The evolution towards toxic megacolon may be the consequence of a transmural infection across the colonic wall deriving from the mucosal ulcerations of colon and sigmoid, and proves that toxic megacolon is not a pecific complication of ulcerative colitis but may appear in the course of any acute inflammatory ulcerative lesion of the colonic wall.

Adrenal Cortex Hormones↗
PubMed1975

Cancer of the gastric stump following operations for benign gastric or duodenal ulcers.

Twenty-seven patients who developed cancer of the stomach after undergoing gastric resection (GR), gastroenterostomy (GE), and vagotomy and pyloroplasty (VP) for benign gastric or duodenal ulcer are reported. The etiology and the pathogenesis of this type of cancer are discussed. Long-term exposure of the gastric mucosa to bile and duodenal and pancreatic secretion reflux seems to create a premalignant potential state. Symptoms and the diagnostic methods of radiologic series, cytology, and endoscopy are discussed. We suggest a curative operative approach and discuss the poor value of palliative procedures. We emphasize the necessity of determining the prognosis with exploratory laparotomy which establishes at the same time the certitude of the diagnosis.

Duodenal Ulcer↗
PubMed1975

[Hemobilia. (Apropos of 5 cases)].

Hemobilia or hemorrhage through the biliary tract is increasing in frequency. With spreading knowledge of the syndrome, the diagnosis is now rarely missed. There is also a real increase due to traffic accidents which often cause liver injuries. The typical triade with digestive hemorrhage, biliary colic and jaundice should always arouse suspicion of hemobilia. Hepatic angiography is the best and most accurate diagnostic method. Accidental or operative trauma constitute the major cause of macroscopic hemobilia where as microscopic hemobilia is a very frequent symptom in gallstone-disease. In this report five cases of different ethiology are described. Three were caused by abdominal trauma. The fourth case illustrates the risk of hemobilia from instrumental exploration of the common duct. Even when this is done carefully it might cause a hemorrhage with formation of obstructing clots. In the last patient there was severe hemobilia due to errosion of the cystic artery by a gallstone, penetrating into the duodenum. The treatment given in the five cases are examples of different methods which may be used, according to the nature of the lesion. In the three cases of traumatic hemobilia one healed spontaneously under angiographic control, one was cured by local hemostasis in the central liver rupture and the third had a successful hepatic resection. In the case with post-operative hemobilia, an obstructing clot had to be removed from the common duct. Simple cholecystectomy cured the patient with hemorrhage from the eroded cystic artery.

Aged↗