Biomedical subjects
Publications and source records attributed to J Champetier.
A cysticohepatic duct drains a particular region of the liver. It represents an anatomical variation of the biliary tree. On the contrary, a subvesicular duct represents an abnormality of the biliary ducts development. It belongs to aberrant biliary ducts (vasa aberrantia) and has all their morphologic characteristics.
Between 1975 and 1980, 42 pancreatic injuries have been managed, they represented 9.5 per cent of abdominal injuries. Nine patients received penetrating trauma and thirty three patients sustained blunt trauma, the majority of them was a road accident. Associated and concomitant injuries of abdominal organs were present in 81 per cent of cases with the pancreatic trauma. More than 66 per cent have multiple brain, thoraco, abdominal, and bones injuries. Thirty two patients have been treated before the sixth hour. The emergency surgical treatment has been conservative in twenty six patients and a primary resection has been performed in twelve patients, (with eleven partial pancreatectomy and one pancreatoduodenectomy). But four patients died on the operating table because they have extensive injuries to several abdominal organs. Postoperative complications were present in 66 per cent of cases. They obliged the drainage of abscesses, three distal pancreatectomy and one pancreatoduodenectomy. The global mortality is 31 per cent, the secondary mortality is 21.4 per cent. The authors conclude thanks to the study of this series and of literature that the frequency of pancreatic trauma increased, and that its gravity is directly related to the number of other organs damages, missed or delayed diagnostic and to an inappropriate emergency treatment, which let necrosis and infection making their deadly evolution.
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The usual radiographic projections do not enable to do a complete diagnosis of the pattern of the calcanear fractures. Horizontal tomograms, performed since 1975 by the authors with a complex movement tomographe show the superior surface of the calcaneus. Compared with the sagittal and frontal tomograms, they are absolutely necessary to know the shape of the fractured calcaneus and to precise the anatomical basis of its treatment.
Though ruptures and "spontaneous" perforations of the rectum and sigmoid are sometimes confused they are very different affections. Ruptures of the rectum or the rectosigmoid junction are lesions due to effort in chronically constipated subjects, frequently having rectal prolapses. They are due to a particular type of trauma. Perforations of the rectum, rectosigmoid junction, or the sigmoid loop arise from a previous acute ulceration of the intestinal wall. Systematic histological examinations may confirm the etiology. A case is reported of rupture of the rectum due to effort. The second case was a double perforation, of the rectum and the rectosigmoid junction, due to a non-specific acute rectocolitis.
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Elementary functional anatomy of the normal abdominal wall and following incisional hernia are described. The treatment of postoperative hernia should be based on this: its object is to restore the morphology and functions of the abdominal wall, in particular its respiratory function. It may be necessary to carry out gradual pneumo-peritoneum before parietal repair. A mersilene mesh was used by the authors in 51 cases. Certain rules should be observed when this prosthesis is placed in position so that the abdominal muscles find the conditions closest to their normal function.
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Hepatic and pelvic arteriography were carried out in one case of trauma of the liver and pelvis. Initial hepatic arteriography did not give more information than per-operative cholangiography. Secondary hepatic arteriography suggests the presence of lesions which, in fact, do not exist. Pelvic arteriography permitted us to localise on one obturator artery, the origin of a voluminous retroperitoneal hematoma. We were able to stop the hemorrhage by embolisation and this facilitated surgical removal of the hematoma.
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The Hackethal's technique of intramedullaring wiring for humeral fracture represents the immobilisation procedure particularly convenient for this bone. This procedure can be realised without special instrumentation with Kirschner's wires and image intensifior. To allow the approach of the fracture, the patient's position is choosed upon the topography of the lesion. The intramedullaring wiring is always done from down to up. Indications for this procedure are: humeral shaft fracture, humeral neck fracture, and fractures of the shaft and of the neck. During the reduction of the fracture, the immoderate use of a image intensifior seams to be the major risk. Hackethal's technique for medullary wiring was used in 21 patients, only one pseudarthrosis was noted. The fonctionnal recovery of the arm is usually realised in three months.
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