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Biomedical subjects

J L Dupas

Publications and source records attributed to J L Dupas.

At least 19 recordsLinked to original sources

Endoscopic diagnosis and treatment of Mirizzi's syndrome.

Mirizzi's syndrome is the name given to common bile duct obstruction secondary to a stone in the cystic duct. The cause of the biliary obstruction is often difficult to establish before operation. We report two cases of Mirizzi's syndrome, diagnosed endoscopically and treated without surgery. One of the patients was treated by drainage of both the common bile duct and the gallbladder associated with monooctanoin dissolution of the gallstone. The other was treated by common bile duct stenting.

Aged

Spontaneous portal venous gas in a patient with Crohn's ileocolitis.

In a 70-year-old man with Crohn's ileocolitis who presented with a sudden fever, ultrasound and computed tomographic (CT) examinations showed hepatic portal venous gas (HPVG). Abdominal plain film was normal. The course was benign with medical management. The authors review previous cases of portal vein gas in intestinal inflammatory diseases.

Aged

[Hepatoid adenocarcinoma of the stomach].

One year after gastric resection for cancer, a 67 year old patient was hospitalized because of a large hepatic tumor with extremely high serum alpha-foetoprotein levels (13,245 ng/ml). Histological and immunohistochemical studies of the gastric tumor revealed hepatoid foci with alpha-foetoprotein and protease inhibitor-producing cells. Histopathological and immunohistochemical features of this and the 8 previously reported cases of hepatoid adenocarcinoma of the stomach are analyzed.

Adenocarcinoma

Gastrointestinal bleeding due to chronic portal vein thrombosis in ulcerative colitis.

The authors report the case of a patient suffering from ulcerative colitis, who had several episodes of digestive hemorrhage due to portal hypertension. Portal hypertension was secondary to chronic portal vein thrombosis. This diagnosis was made on the venous phase of celiac and mesenteric angiography. The authors review the published cases of ulcerative colitis with portal vein thrombosis and discuss the possible etiologic factors: hypercoagulability, thrombocytosis, and intraabdominal sepsis.

Angiography

Fibrosing alveolitis and hepatitis B surface antigen-associated chronic active hepatitis in a patient with immunoglobulin A deficiency.

Fibrosing alveolitis is described in a 22 year old woman with immunoglobulin A (IgA) deficiency and hepatitis B surface antigen (HBsAg)-associated chronic active hepatitis. At lung biopsy HBsAg was detected by indirect immunofluorescence in the alveolar space but not in the septal fibrosis. We discuss the possible relationships between IgA deficiency on the one hand, and HBsAg-associated lung and liver diseases on the other hand.

Adult

Unconjugated hyperbilirubinemia during treatment with chenodeoxycholic acid.

The authors describe a slight but significant increase in the serum levels of indirect-reacting bilirubin in gallstone patients after 3 and 6 mo of treatment with chenodeoxycholic acid. A return to pretreatment values was noted at 9 mo. The mechanism of this abnormality remains unclear. Two explanations are theoretically possible: a subclinical hemolysis or a modification of the hepatic transport and/or the conjugation of bilirubin.

Chenodeoxycholic Acid