Biomedical subjects
Publications and source records attributed to J Barthel.
An arterio-venous fistula can be defined as being a vascular anomaly in which there are one or more direct or indirect communications between an artery and a vein, without the capillary network being involved, this latter therefore being short-circuited. After the presentation of five cases, the authors review the literature on the subject.
During the last six years, the authors treated 44 patients for a ruptured abdominal aneurysm. Three of these patients had a spontaneous aorto-caval fistula and their clinical cases are described. The special diagnostical and therapeutical features of this rare complication are emphasized.
The diagnosis of mycotic aneurysms remains rather difficult. When a mycotic aneurysm is found, two therapeutic measures should be taken without delay: on the one hand an antibiotherapy which is started preoperatively and continued at least six weeks postoperatively, and on the other hand a surgical intervention. In this review, the authors present three types of operations: ligation and excision of the aneurysmal mass, restoration of the arterial tree with a venous graft or extra-anatomical bypass with prosthetic material.
The commonest complication of an atherosclerotic popliteal aneurysm is thrombosis but we report a case in which rupture occurred. It is generally accepted in the management of the popliteal aneurysm, that a prophylactic surgical repair is the treatment of choice. Of all available graft materials, the autogenous saphenous vein remains the best material for arterial reconstruction. In the case reported, excision of a ruptured popliteal aneurysm with end to end anastomosis was performed. The signs and symptoms of popliteal aneurysm are discussed and the literature is reviewed.
In this study, we reviewed 204 cases of acute appendicitis out of 248 appendectomies. They were classified into three groups: acute appendicitis, localized peritonitis and generalized peritonitis. The morbidity is analyzed according to an eventual peritoneal drainage.
Primary mediastinal tumours (PMT) are rare, they include many different histological types, but lymphomas, thymomas and neurological tumours make up most of these tumours. Their symptomatology is often poor and they are in many cases discovered by routine thoracic radiography. Diagnosis mainly relies on medical imagery and on biopsy by mediastinoscopy or by CT-Scan controlled needle puncture. The treatment depends on the histological type (radiotherapy, chemotherapy, surgery). Median sternotomy is preferred to tackle anterior and middle mediastinum PMT, since it offers a large operative field and is more comfortable for the patient than classic thoracotomy, which will be reserved to tackle posterior mediastinum PMT.
A forty-six-year-old, non smoker, patient presented with an intermittent claudication of the right calf, clinically compatible with a low popliteal artery obliteration. Arteriography showed an irregular intercondylar popliteal artery and oblitered low popliteal and anterior tibial arteries. Surgical posterior access showed a faulty insertion of the mediate gastrocnemius caput responsible for popliteal artery entrapment syndrome and for aneurysmal dilatation of the popliteal artery above compression. As far as we know, this form of popliteal artery entrapment syndrome has not been published yet.