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Biomedical subjects

J Valayer

Publications and source records attributed to J Valayer.

At least 109 records · Page 6Linked to original sources
PubMed1979

[Idiopathic megaoesophagus in the child. A series of 17 cases treated surgically (author's transl)].

The authors undertook a retrospective study of a series of 17 cases of idiopathic megaoesophagus seen over a period of 25 years in two paediatric surgery departments. Age distribution was regularly between 20 months and 15 years. No neonatal nor familial forms were seen. Symptoms were dominated by regurgitation and dysphagia. Weight loss was an almost constant feature. Heller's operation, via an abdominal approach with retro-oesophageal valve of the tuberosity fixed to both edges of the myotomy, was the operation proposed. In one case of recurrent megaoesophagus operated upon elsewhere a Thal operation gave a good result with a follow up of 8 years. Immediate clinical and radiological results were favourable in the great majority of cases : 16 cases out of 17. Long term results (follow up of more than 5 years in 8 patients) were also favourable. However one patient was sometimes troubled by regurgitations due to persistent achalasia and a grave failure occured in a patient who five years after a Heller operation developed a peptic stenosis of the lower oesophagus. No recurrence of megaoesophagus was seen. The authors emphasise the importance of the prevention of gastro-oesophageal reflux and the value of oesophagoscopy and of manometry in cases where the result of a Heller's operation is imperfect.

Adolescent↗
PubMed1976

Hepatic porto-enterostomy or cholecystostomy in the treatment of extrahepatic biliary atresia. A study of 49 cases.

Hepatic porto-enterostomy or cholecystostomy (Kasai's procedure) was successful in restoring bile flow in 31 of 49 patients with "noncorrectable" extrahepatic biliary atresia. However, all but one of the 31 developed acute or chronic complications such as cholangitis, bile peritonitis, or portal hypertension. During a five-year follow-up period, 26 (53%) died while 9 of the 23 survivors continue to manifest chronic or recurrent cholangitis. Thirteen of the 19 survivors who are more than one year of age have developed portal hypertension. These complications limit the prognosis of infants with "noncorrectable" biliary malformations.

Bile Ducts↗
PubMed1975

Experience with choledocal cyst.

In a series of ten children operated upon for congenital choledocal cyst, it was noted that the diagnosis had often been delayed because of intermittent or moderate symptoms during the first year of life. We favor resection of the cyst, advocated by many authors recently, but it should be emphasized that this procedure is not without risk and may be quite a difficult undertaking. Late results were satisfactory on the whole, even in one child with severe portal hypertension. However, the moderate fibrosis found at operative biopsy and the still slightly enlarged liver at follow-up examination are reasons for long-term observation of these patients.

Bile Ducts, Intrahepatic↗
PubMedDate not supplied

Pigment gallstones of the common bile duct in infancy.

Ten infants of less than 6 months of age presented with cholestatic jaundice and gallstones. Jaundice occurred after a lag period, and sepsis was present in three children. Ultrasound examination showed dilatation of intrahepatic and extrahepatic bile ducts in eight patients and detected cholelithiasis in three. Percutaneous transhepatic cholangiography and/or surgery allowed separation of the patients into two groups: (i) six children with lithiasis in the distal common bile duct, and (ii) four children with lithiasis associated with bile duct perforation at the junction between the cystic and common bile ducts with gallstones probably secondary to bile stasis and infection. Surgical treatment was confined to removal of calculi and drainage in eight children; biliary reconstructive surgery was necessary in the other two who had serious biliary duct lesions. No recurrence was observed after 1 to 7 years. The pigmentary nature of cholelithiasis was established by stone morphology in all cases, and by bile and stone analysis in several cases.

Bile↗
PubMedDate not supplied

[Neonatal hypoglycemia due to hyperinsulinism secondary to Langerhans' polyadenomatosis. Recovery after pancreatectomy].

Report of a case of a neonatal hypoglycemia detected at the 11th hour of life, secondary to a Langherans polyadenomatosis in a girl with an hemihypertrophy. Pre- and post-operative tests are reported. In case of neonatal hypoglycemia, the criteria leading to the diagnosis of hyperinsulinism, i.e. the only neonatal hypoglycemia with surgical treatment are reviewed. Except in the case of adenoma, the pancreatectomy should be performed subtotally. The best time for surgery is as soon as the 3rd week, in order to preserve the cerebral development.

Adenoma, Islet Cell↗
PubMedDate not supplied

[Sacrococcygeal malformations: a report on 67 cases (author's transl)].

A series of 67 personal observations of sacrococcygeal malformation are reported, and these are reviewed together with the 249 cases in the published literature. The clinical picture and pathogenic mechanisms are discussed, and the frequent association of other congenital abnormalities, more particularly of the ano-rectal type, is stressed. The functional results obtained depend on the severity of the neurological lesions, associated malformations, and the quality of the treatments used.

Abnormalities, Multiple↗