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J Leborgne

Publications and source records attributed to J Leborgne.

139 records · Page 8Linked to original sources
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[Abdominal intercostal hernia. Report of four cases (author's transl)].

The authors report 4 recent cases of abdominal intercostal hernia and in the light of other cases in the literature, discuss the clinical presentation of this curious and rare disease. Presenting all the characteritics of an uncomplicated hernia, abdominal intercostal hernia is an easy diagnosis on a single clinical examination. Further respiratory and digestive investigations are however essential before undertaking a surgical cure of this hernia at the limit of the thorax and abdomen. Treatment is purely surgical. Instead of the classical treatment by the direct approach, where the risk of relapse is important, one should prefer the transperitoneal approach with use of an inert supple prosthesis. This method gave excellent results with a follow-up of from 1 to 3 years.

Abdomen↗
PubMedDate not supplied

[Encapsulating perihepatitis. Report of four cases (author's transl)].

The authors report 4 cases of encapsulating perihepatitis, the macroscopic appearance of which corresponded to the morphological definition of the condition. The circumstances surrounding the diagnosis were very variable: association of ascites and porial hypertension, sub-obstructive syndrome due to associated encapsulating peritonitis, chance discovery at laparotomy or an unexpected finding at autopsy. The diagnosis was made pre-operatively in 2 cases by peritoneoscopy. All the patients had portal hypertension with, in particular, evidence of oesophageal varices. Three patients were treated surgically: hepatic decortication in all cases, combined in one another with umbilico-caval anastomosis. In all cases, the underlying perihepatic matrix produced epiglissonian fibrosis. However the inderlying hepatic lesions varied, ranging from definite cirrhosis to mild fibrosis. In one case, cirrhosis was associated with a hepato-cholangioma with nodular metastatic spread. The prognosis depended essentially upon the effects of general condition and the severity of hepatic lesions. In the light of cases reported over the past twenty years, the authors review the various clinical, pathogenic and therapeutic aspects of encapsulating perihepatitis.

Aged↗
PubMedDate not supplied

[Successful medical treatment of post-traumatic tracheo-oesophageal fistulae (author's transl)].

Tracheo-oesophageal fistulae secondary to closed traumatic lesions of the thorax are rarely encountered, and only 38 cases have been reported in the published literature. The causal accident is usually perforation due to steering wheel projection or a crushing injury in a young subject (77% less than 30 years old) with a supple thorax, and parietal lesions are rarely observed. The initial lesion is rupture of the trachea with oesophageal confusion, usually above the level of the carina. The only diagnostic clinical sign is cough on swallowing, and diagnosis suspected on bronchoscopy is confirmed by radiological examination with a contrast medium. Urgent surgical treatment is necessary to repair the tracheal lesion. Secondary disunion may be observed (8--34). The particular characteristic of the cases presently reported was the secondary formation of a fistula after tracheal repair. Direct enteral feeding led to closure of the communication in 6 weeks.

Adult↗
PubMedDate not supplied

[Is portacaval anastomosis still valid treatment for portal hypertension in alcoholic cirrhotic patients?].

Mortality and quality of survival after portacaval anastomosis in cirrhotic patients are such that the validity of the operation was investigated during a retrospective study of 242 cases, operation being for hemorrhage and involving emergency or delayed surgery. Operative mortality was higher in emergency cases, but was improved by stricter selection criteria, particularly of pathological features. Cause of death from secondary factors varied during the two years following anastomosis, with perhaps a high frequency of hepatic failure. Recurrence of hemorrhage was a serious complication often related to hepatic insufficiency, while the onset of combined jaundice-edema-ascites (1 out of 4 patients) was frequently the result of continued alcohol abuse. Portacaval encephalopathy (24,4%) did not worsen the vital prognosis, and was severe in only 3 cases. Alcohol intoxication was very frequent in minor forms. Edema of the lower limbs (34,4% of cases), a frequent complication, appeared to result mainly from hemodynamic causes. A return to work was not possible in 20% of patients, but in only 12% was this due to the anastomosis. Portacaval anastomosis would not, therefore, appear to alter survival of patients from complications of cirrhosis. It suppresses the hemorrhagic risk, however, and the course of the disease is then related only to the cirrhosis and to its stability if abstinence is maintained.

Adult↗
PubMedDate not supplied

Holoprosencephaly classified by computed tomography.

Five cases are presented to demonstrate the computed tomographic (CT) spectrum of holoprosencephaly. The classifications of alobar, semilobar, and lobar types A and B holoprosencephaly are each represented, with an additional case of semilobar holoprosencephaly complicated by a subdural effusion.

Brain↗
PubMedDate not supplied

[Surgery of the pudendal nerve in various types of perineal pain: course and results].

In 1989, we reported our thoughts on the neurophysiological and anatomic aspects of pudendal nerve involvement in certain types of perinal pain. Since that time, the surgical approach has been modified. Here we report our follow-up of 40 patients with 48 operated nerves. Follow-up ranged from 6 months to 7 years and outcome revealed improvement in 67% and no change in 33%. Thus surgery had been useful in two-thirds of the cases; in 44% of the patients, there was either a frank improvement or no change. Early diagnosis appears to be the determining factor in improving results. Operating for the canal syndrome must be performed before lesions to the nervous trunk become too important.

Adult↗
PubMedDate not supplied

[Hepatic and renal angiomyolipoma].

Angiomyolipoma is a benign mixed mesenchymal tumor. It is a well known entity in the kidney, but very rare in the liver. A case of renal and hepatic angiomyolipoma without no evidence of tuberous sclerosis is presented. This association has been previously described only once before. Radiologic and ultrasonographic findings may be suggestive of the lesion, showing both fatty and hypervascular components. The definitive diagnosis requires histologic and immunohistochemical confirmation by fine needle aspiration biopsy. Surgical excision is unnecessary unless abdominal discomfort is present or malignant tumor is not completely ruled out.

Adult↗