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Biomedical subjects

L Hannoun

Publications and source records attributed to L Hannoun.

At least 109 records · Page 6Linked to original sources
PubMed1984

Postoperative peritonitis due to gastric and duodenal fistulas. Operative management by continuous intraluminal infusion and aspiration: report of 23 cases.

A new surgical procedure is presented for the management of postoperative peritonitis due to a leak from a suture line in the stomach or the duodenum. At re-operation, an intraluminal unit made of three silicone tubes is inserted through the fistula into the bowel lumen. Extraluminal drains are placed near the fistula. A Witzel jejunostomy is constructed in order to provide continuous high energy enteral support. Intraluminal infusion and aspiration starts immediately after operation. Twenty-three patients have been treated according to this technique. Five died (22 per cent): one from mediastinitis and four from complications unrelated to the fistula. Three (13 per cent) patients developed recurrent abdominal abscesses and underwent re-operation for drainage with no mortality. In the first 2 weeks after operation, most of the discharge was collected by the extraluminal drains. Thereafter the intraluminal unit collected the majority of the fluid, thus allowing the extraluminal drains to be removed. At an average time of 27 days after operation the intraluminal unit was withdrawn. The external fistula created by this technique healed spontaneously in 15 of the 18 survivors, and was surgically closed in three, with no complication. This procedure prevents the recurrence of intra-abdominal sepsis and local complications due to the enzymatic action of the gastroduodenal secretions.

Adult↗
PubMed1984

Surgical anatomy of liver segment IV.

Classical studies of the anatomy of the liver have led to the wide practice of hepatic resection. The difficulties encountered in the course of either right hepatectomy enlarged to include segment IV or left hepatectomy are mainly related to the vascular relations of this liver segment. This paper presents a summary of data from the literature concerning segment IV of the liver, as well as the results of experimental study via an original technique of resin injection of the portal vasculature and biliary drainage of this segment. The relations of the portal pedicles of segment IV with the bile duct originating from the confluence of the ducts draining segments II and III and with the left paramedian branch of the portal vein are described. Knowledge of these anatomical relations is essential to the proper execution of major hepatectomy.

Bile Ducts↗
PubMed1984

Anatomical and physiological basis of parietal treatment of severe peritonitis and evisceration.

The failures observed in attempts to obtain abdominal closure "at all costs" and the risks and difficulties of laparostomy led us to develop a technique of exclusive cutaneous cover to treat cases of severe peritonitis and evisceration with or without exposed fistula. This method is based on certain anatomical features of the anterolateral abdominal wall and its physiological properties when eventration or evisceration is present. The forces of parietal dehiscence were determined in 6 patients having undergone major surgery of the digestive tract. The magnitude of these forces, the neccessity of obtaining biological protection and the structure and physiology of the superficial layers of the abdominal wall require a cutaneous cover with traction-free sutures via cutaneoaponeurotic incisions of relaxation. The rich vascularization of the abdominal wall, the number and topography of the perforating arteries and the existence of hypodermal, subdermal and subpapillary anastomoses allow the surgeon to perform extensive cutaneoaponeurotic mobilization.

Abdominal Muscles↗
PubMed1984

Radiological anatomy of the right gastroepiploic artery.

Most gastroplasties performed to replace the esophagus are vascularized by the right gastroepiploic artery alone. Its origin, course and anatomical relations are classical and subject to little variation. Conversely, its mode of termination and relations to the left gastroepiploic artery have received quite different descriptions in the literature. This report describes the radiological anatomy of the right gastroepiploic artery based on arteriograms in 50 subjects. The right gastroepiploic artery was much larger (diameter 1.7 to 2.6 mm at its origin) than the left (absent in 3 cases) in our series. Direct end-to-end anastomosis of these two arteries, as described in classical reports, was found in only 23.5% of cases.

Angiography↗
PubMed1984

Development of the human pancreas: variations and pathology. A tentative classification.

The pathology of the pancreas is sometimes related to the embryological development of the organ. The first part of this paper is a presentation of the embryology, morphogenesis and cytogenesis of the pancreas. A tentative classification is then proposed to group together the lesions directly related to anomalies of the position and differentiation of the pancreatic buds. Pathological processes affecting the pancreas can be divided into those related to the ducts and those related to the parenchyma of the gland. In each case anomalies arising at a given stage of development lead to different diseases of the pancreas.

Chronic Disease↗
PubMed1984

[Arteriovenous fistula of splenic vessels after splenectomy].

Arteriovenous fistula of the splenic vessels is a rare complication of splenectomy since only 7 cases (including the case reported herein by the authors) are presently known. Simultaneous ligation of the vessels seems to be an important causative factor; enzymatic necrosis of the vessel walls due to a minute peroperative trauma to the pancreatic tail is also a plausible mechanism. All fistulas have been recognized within two years after splenectomy. Clinical findings consist of various signs among which a continuous left flank murmur is the most constant. Cardiac repercussions are usually lacking. The fistula induces hepatic lesions which never evolve towards hepatic sclerosis or cirrhosis and are reversible after closure of the arteriovenous communication. Portal hypertension is present only when associated hepatic lesions block the portal blood flow. Until recent years, surgical closure of the fistula was performed with satisfying results. Recently, non surgical closure has become possible and seems suitable in poor-risk patients.

Arteriovenous Fistula↗
PubMed1983

[Anatomic study of the left inferior diaphragmatic vein (vena phrenica inferior sinistra)].

The anatomy of the left inferior phrenic vein is poorly understood. It can be exposed by transecting the left triangular ligament and clearing the hepatic veins. We inspected twenty embalmed specimens that were injected with Rhodorsil. Generally, the vein has its origin above the diaphragm near the apex of the heart. After traversing the diaphragm, the vein receives two collateral veins, in front of the left triangular ligament. One is located anteriorly and to the right of the vein, the other one is situated behind and to the left. The phrenic vein continues laterally, passing posteriorly to the triangular ligament, or rarely, when the coronary ligamentum is wider than usual, the vein will pass through it as well. In 74% of the case, the vein terminates into the left side of the left hepatic vein. Three dissections appeared to be very interesting: --in one, the vein followed the free margin, then the hepatic margin of the triangular ligament, receiving accessory hepatic veins, --in another, the vein joined the right inferior phrenic vein in front of the inferior vena cava, --in the third one, the vein followed the left inferior phrenic artery, to join the left suprarenal vein, then terminating in the left renal vein.

Adult↗
PubMed1981

[Rupture of the liver secondary to external cardiac massage in a patient with coronary disease : recovery after partial hepatectomy and aortocoronary by-pass (author's transl)].

A 55-year-old man developed ventricular fibrillation during an attack of acute Prinzmetal-type angina, and was treated by external cardiac massage and a defibrillator. Hemorrhagic shock due to laceration of the left side of the liver developed 48 hours later. A liver lobectomy was performed. The postoperative course was uneventful enabling a coronarography examination to be followed by an aortocoronary by-pass, good results being still present after one year. Complications of cardiac massage, especially those involving the liver, are discussed, as well as the treatment of traumatic liver lesions.

Coronary Artery Bypass↗
PubMed1980

[Thyroid metastases from renal tumours: 3 cases (author's transl)].

Metastatic tumours from clear cell renal cancer were found in 3 out of 4 000 thyroidectomy specimens. These tumours appeared on scintigrams as low density nodules, one to three in number, and were accompanied in one case by signs of hyperthyroidism. They were treated by partial excision 4, 5 and 7 years after nephrectomy. One patient relapsed, was re-operated upon 2 years later and is still alive after one year. The other two patients showed no sign of relapse after 2 and 4 years respectively. When the renal history is unknown it is difficult histologically to differentiate these tumours from clear cell epitheliomas of the thyroid gland.

Adenocarcinoma↗