[Nephrotoxicity of high-dose melphalan].
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Biomedical subjects
Publications and source records attributed to M Mousseau.
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The authors present a rare case of teratoma developed in the cervical region of a female teenager. Comparing this case to the literature, they study the clinical aspects which are different according to the age of the discovery, pointing out the most frequent case of the newborn and they study the histological findings setting out the diagnosis. Prognosis depends on the maturity degree of the tissues; it is more often than not excellent after surgical exeresis with child contrary to the seldom adult cases of which the evolution is quickly distressing.
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The authors report 92 cases of trauma of the liver which survived initial operation and study the special problems linked to hepatic sequestration. They analyse the factors which favour the appearance of these sequestra and the methods of diagnosis using clinical, laboratory, arteriographic and scintigraphic data. Relatively frequent (8,4 p. 100), these complications require fairly early surgical treatment. They are commonly localised to the dome of the liver and this renders their approach difficult. A low postero-lateral thoracotomy with resection of the 10 th or 11 th rib, followed by sequestrectomy and drainage, seems to them ideal approach. The pleuropulmonary sequelae are minimal.
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The diagnostic and therapeutic problems involved in 29 cases of isolated hepatic tumors have been presented. In nine cases the hepatoma was discovered during emergency treatment for complications. Selective arteriography was the most accurate method of establishing the etiologic diagnosis. Suprahepatic phlebography indicated the possibilities for surgical treatment. These possibilities are not influenced by the volume of the tumor, but are closely dependent on damage to the suprahepatic vascular system. Effective surgery was performed in 22 cases, of which 14 were excisions.
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The authors report their experience of 134 cases of porta-caval anastomosis for alcoholic cirrhosis. From their experience, they draw up the logical indications for this operation, i.e. in order to ensure better survival than that of patients treated in other ways. They suggest routine study of surgical biopsy, even as an emergency. This biopsy permits them to recognise which cases are liable to be progressive; in severe cases, surgery should not be undertaken. Thanks to this selection, the operative mortality is reduced to that of any other severe operation (6 p. 100) and later survival is improved owing to absence of recurrent hemorrhage.
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