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Biomedical subjects

J L Lortat-Jacob

Publications and source records attributed to J L Lortat-Jacob.

At least 19 recordsLinked to original sources
PubMed1978

[Palliative methods permitting oral feeding in patients with carcinoma of the esophagus (author's transl)].

405 patient with carcinoma of the esophagus were operated on the unit from 1st January 1972 to 15th February 1977. Among these 405 patients, 55 underwent prolonged esophageal intubation and 24 a palliative operation. We considered successively the various methods of prolonged intubation and the various types of palliative operation possible. At the end of this study, it appears that palliative surgery for carcinoma of the esophagus owing to the severity of the operation and the high post-operative mortality and the doubtful functional results, should be reserved for eso-respiratory fistulas, per-operative loss of esophageal blood supply, and the contra-indications to prolonged intubation. On the other hand, it seems that the indications for prolonged intubation should be enlarged at the expense of those for gastrectomy, excluding however stenosing or too extensive carcinomas and carcinoma of the upper.

Administration, Oral↗
PubMed1977

[Major esophageal hemorrhages of unusual origin. A poorly known entity].

Nine cases of severe gastrointestinal haemorrhage as the presentation of oesophageal lesions are reported. Haemorrhages complicating oesophageal varices, carcinoma of the oesophagus and oesophageal surgery were eliminated from the study, as were haemorrhages associated with hiatal hernias or Mallory-Weiss syndrome. Amongst these 9 cases of severe haemorrhage, 5 were due to an ulcer of the oesophagus, 2 to acute oesophagitis, 1 to rupture of the oesophagus and one to a traumatic aneurysm of the aorta rupturing into the oesophagus. The location and cause of bleeding were determined only 3 times before operation and only when a fibroscopic examination had been carried out. At fibroscopy, an irregular lesion responsible for a severe haemorrhage has every chance of being a benign ulcer and not a carcinoma. Treatment directed at the aetiology was carried out in 6 cases and success obtained in 3 patients. The aetiological diagnosis who was not made in 3 patients, who died. The aetiology, diagnosis and therapeutic approach required in such cases of severe haemorrhage of oesophageal origin are considered. In the light of these cases, a possible oesophageal aetiology should be considered as a possible cause of an unexplained severe gastrointestinal haemorrhage. An attempt at proving such a hypothesis by fibroscopy is necessary and, in general, urgent thoracotomy since the bleeding is in most instances of arterial origin.

Adult↗
PubMed1977

[The resistance to infection of digestive sutures. Experimental study (author's transl)].

The authors study the effects of severe sepsis due to pathogenic gems in large quantity an healing of the suture of the ileum in the rabbit. Contamination of the suture did not lead to any breakdown of the suture whatever the germ. These experimental facts, compared with the data in the literature suggest that the peritoneal serosa ensures efficacious anti-infectious defence, permitting healing of intra-peritoneal digestive sutures in spite of the septic nature of the intestinal contents.

Animals↗
PubMed1975

[Benign postoperative intrahepatic cholestasis].

The authors report the clinical, biochemical, histological and etiologic characteristics of 24 patients with the syndrome of benign intra-hepatic post-operative cholestasis. Jaundice appeared early in the post-operative period, from the first to the 12th post-operative day. All patients had received blood transfusions. In 23 patients, the post-operative course was complicated, chiefly by local infection or septicemia. Hyperbilirubinemia ranged from 2 to 28 mg per 100 ml and was mainly conjugated; serum alkaline phosphatase activity was normal or moderately elevated; in 3 patients, it was markedly elevated; serum glutamic-pyruvic transaminase activity was normal on 7 patients, moderatly increased in 15, and markedly increased in one. Liver histology was normal in 6 patients, and showed minimal lesions (cholestasis and slight portal inflammatory changes) in 3. Jaundice did not appear to modify the final outcome. It appears to be due both to increased production of bilirubin (as a result of blood transfusions) and to decreased excretion of bilirubin by the liver (as a result of the surgical operation and of infection).

Acute Kidney Injury↗