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Biomedical subjects

M Kehila

Publications and source records attributed to M Kehila.

At least 19 recordsLinked to original sources
PubMed2001

[Intestinal invagination after vagotomy in adults].

Intestinal intussusception is a rare condition in adults. In most cases, it is caused by a benign or malignant intestinal tumor. Primitive forms are infrequent, and their occurrence following troncular vagotomoy has never been described in the literature, according to our knowledge. Two cases of post-vagotomy jejuno-jejunal intussusception are reported.

Adult↗
PubMed1994

[Partial splenectomy in thalassemia major. Apropos of 19 cases].

Nineteen cases of B Thalassemia have benefited from partial splenectomy at the General Surgery Service of Farhat Hached Hospital in Sousse (Tunisia). The partial splenectomy indication was to reduce hypersplenism, thus transfusion needs, to suppress splenic pain and to conserve a splenic remnant, which preserves patients' immunity. The operation was in reality a subtotal splenectomy keeping the lower pole in all cases. We had no per-operatory complication. The preoperatory bleeding was not more serious than in total splenectomy. In all the patients, we noticed reduction of about half the transfusion need, except one who had also a chronic deficit in glyco-six phospho-dehydrogenase. The average hemoglobin rate increased from 60 g/L in the pre-operatory to 80 g/L after the operation. Consequently, this reduction of transfusion needs results in the decrease of the hemochromatosis, which is one of the main complications of hypertransfused thalassemia.

Adolescent↗
PubMed1993

[Partial splenectomy requiring ligation of splenic vessels. Apropos of 40 cases].

Conservative treatment of the spleen is generally based on segmental terminal vascularization of the spleen. The practise of partial splenectomies in the case of major trauma and hilar hydatid cyst led us to perform subtotal splenectomies after splenic vessel ligation. The upper pole splenic remnant after reduction of its volume, remains vascularized by other short vessels through the gastro-splenic ligament. The lower pole splenic remnant remains vascularized by the left gastro-epiploic artery. The follow-up of 40 subtotal splenectomies performed in these conditions revealed better results than those obtained after spleen autotransplantation in the omentum. Conservation of all the vessels of the gastro-epiploic ligament allows gastric transposition of the spleen.

Echinococcosis↗
PubMed1993

[Cysto-hepatic ducts; surgical consequences. Apropos of 29 cases].

Cysto-hepatic ducts are a rare entity constituting less than 2% of biliary tract operations. Twenty-nine cases have been encountered in our General Surgical Service between 1980 and 1989. The frequency is about 2.3% in a series of 1,265 operative and/or postoperative cholangiographies analysed during the same period. Cystohepatic ducts were discovered in 3 cases at dissection, in 10 cases on operative cholangiography, in one case after biliary tract lesion, and in 15 cases on postoperative cholangiography. The cystohepatic duct was voluntarily or involuntarily respected in 23 cases, voluntarily ligated in one case, involuntarily in 2 others, cut and drained outside in one case, injured and repaired in one case, and cut in another. From our experience, we conclude that the roles of dissection of the cystic duct and the recognition of well known biliary bifurcation do not permit in all cases to avoid common bile duct lesions, particularly in the presence of an unforeseeable and dangerous variant such as a cystohepatic duct draining a large hepatic territory. As a result, the first stage of cholecystectomy should not be dissection of the biliary bifurcation, ligation of the cystic duct and its intubation but especially dissection of all elements of Budd's triangle before intubation of the supposed cystic duct. This avoids leaving upstream from the sectioned cystic duct, an hepatic territory not drained by the common bile duct. A good quality systematic operative cholangiography reveals in the other cases this anatomical variant and constitutes an essential medico-legal document for the patient's and surgeon's safety.

Adolescent↗
PubMed1990

[Conservative treatment of the spleen. Report of 50 cases].

From 1983 to 1989, 50 patients have been treated by spleen conservation. Traumatism was iatrogenic in 9 cases, caused by public highway accidents in 31 cases, domestic accident in 9 cases and penetrating trauma in one case. Spleen conservation includes: 26 partial splenectomies, 11 cauterisations, 10 sutures, 5 auto-transplantations, and 3 abstensions after laparotomy and little spleen trauma. Three deaths were observed secondary to cerebral trauma, and two complications have been seen: one during the operative solved by total splenectomy, and one rebleeding after splenorraphy, reoperated and splenectomy was performed with good evolution. The follow-up of partial splenectomy showed that splenic remnant keeps an epuration activity.

Adolescent↗
PubMed1989

[Exogastric cystic schwannoma. Observation of a case].

The authors report a case of giant gastric schwannoma with dominating extra-gastric development and a cystic component simulating a pancreatic pseudo-cyst on ultrasound and computed tomography examination, the diagnosis was made only at surgery that consisted in total gastrectomy. The rarity of these tumors, their diagnostic difficulties and the particularities of their surgical treatment are outlined.

Aged↗