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Biomedical subjects

P Descombes

Publications and source records attributed to P Descombes.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Intraduodenal development of diverticula of the lower choledochus. Apropos of 2 cases].

Two cases of intraduodenal development of a low choledochal diverticulum were observed during the last ten years. Preoperative diagnosis of this biliary malformation is difficult. Clinical presentation consisted of chronic upper abdominal pain and high gastrointestinal obstruction, without either cholangitis or pancreatitis. In both patients, treatment consisted of resection of the diverticulum and suture of its neck via a transduodenal approach. The post-operative course was uneventful and long-term follow-up (2 and 11 years) is satisfactory, showing that cure has been achieved by means of this simple and radical procedure. This particular biliary anomaly must therefore be distinguished from other diverticula of the common bile duct, because of its clinical presentation, diagnostic approach and treatment required.

Adolescent↗
PubMed1989

[Biopsies of the endoscopically normal rectum and colon: a necessity. Incidence of collagen colitis and microscopic colitis].

Collagenous colitis and microscopic colitis are histologic entities which do not have corresponding endoscopic features. Their precise incidence and role in the development of intestinal symptoms are poorly known. The aim of this study was to determine the frequency of these histologic abnormalities in patients with endoscopically normal colon and to correlate these findings with abdominal symptoms. Total colonoscopy was performed in 132 consecutive patients, 81 females and 51 males, aged 19 to 83 years (mean: 47.8 years). Patients complained of abdominal pain and/or diarrhea (66 cases), normal bowel transit or constipation (66 cases). Subjects were prepared for colonoscopy with polyethylene glycol 4,000. Three to 8 biopsies were taken from the rectum and the different parts of the colon. Histologic abnormalities were found in 36 patients (27.2 p. 100): collagenous colitis (7 cases), microscopic colitis (21 cases), and melanosis coli (8 cases). The frequency of diarrhea was significantly higher in patients with collagenous colitis and microscopic colitis than in those with melanosis coli or normal colonic mucosa. These results clearly demonstrate that routine biopsies of the rectum and colon are useful in patients with abdominal symptoms, particularly diarrhea, and normal endoscopy.

Adult↗
PubMed1985

[Incidence of esophageal cancer synchronous with upper aerodigestive tract cancers (100 cases): value of vital staining with lugol and toluidine blue].

A number of studies have demonstrated a high incidence of synchronous or metachronous esophageal carcinoma in association with carcinoma of head and neck. Carcinoma of the esophagus must be systematically looked for before the treatment of head-neck carcinomas and during follow-up. The aim of this study was to determine the incidence of synchronous esophageal carcinoma in patients with head and neck carcinoma and to evaluate the advantages of lugol and toluidine blue vital staining in fiberoptic endoscopy. One hundred patients (97 males and 3 females, mean age 54.9 years) were studied. A fiberoptic esophagoscopy was performed in all patients. Vital staining was realized with 5 p. 100 lugol in 40 cases and with 1 p. 100 toluidine blue e in 20 cases. Squamous cell carcinoma of the esophagus was observed in 12 patients, typical grossly in 5 cases and occult in 7 cases. In these latter cases, lugol (2 cases) or toluidine blue (5 cases) stain facilitated the forceps biopsies. Histological examination was positive in all cases. The incidence of esophageal carcinoma synchronous to carcinoma of the mouth was high (35.3 p. 100). Lugol vital staining seems to be sensitive, non-specific and easy to realize. Toluidine blue staining calls for a more difficult and prolonged technique. Although it can reveal occult carcinoma, false positive or negative results may be observed.

Adult↗
PubMed1984

[Gardner syndrome treated by total colectomy with preservation of the internal sphincter. Apropos of 3 cases].

Familial polyposis and more particularly Gardner's syndrome is a difficult affection to treat in children, due to the risk of degeneration of polyps. Two factors are accepted by all authors as being of major importance: the need for early treatment to avoid degeneration; the advantage of maximum mucosal excision to avoid repeated follow up examinations and removal of further polyps from the remaining rectum. Three cases of familial polyposis and Gardner's syndrome were treated by either total colectomy and rectal mucosectomy (2 cases) or a partial Reifferscheid procedure (1 case). Two problems related to prognosis appear to be solved by this procedure: the need to operate on a child lacking clinical symptoms, and to obtain valid continence with a minimum of suveillance after surgery.

Anal Canal↗
PubMed1983

[Upper esophageal varices. Study of 6 cases and review of the literature].

Distal esophageal varices are most frequently associated with portal hypertension, while varices of the upper esophagus are occasionally observed in patients with vena caval obstruction. One hundred and nineteen cases of upper esophageal varices (downhill varices) have been reported in the literature. We report 6 cases (4 men and 2 women), with vena caval obstruction. Upper gastrointestinal hemorrhage occurred in one patient. Endoscopy showed varices in the proximal third of the esophagus in 5 patients and in the proximal half of the esophagus in the other patient. Superior vena cavogram demonstrated total or partial occlusion of the vena cava in 6 cases, with opacification of the right azygos vein in 4 cases and thrombosis of this vein in one case. Superior vena caval obstruction was secondary to malignant lymphoma in 2 cases, to malignant thymoma in 2 cases, to malignant thyroid tumor in one case and to anaplastic bronchogenic carcinoma in one case. Clinical symptoms of vena caval obstruction are present in 91.4 p. 100 of the cases in the literature. Upper gastrointestinal hemorrhage are observed in 7.6 p. 100 of cases. It is generally agreed that the predominant factors involved in the determination of the downward extension of varices along the esophagus are the level of superior vena caval obstruction and its duration. Because of the risk of digestive hemorrhage and of the topographic meaning of the degree of extension, upper esophageal varices should be routinely searched in patients with vena caval hypertension.

Adult↗
PubMed1982

The effect of protease inhibitors on the immune response in mice.

The effect of protease inhibitors on the immune response in mice was investigated. Soybean inhibitor, aprotinin, alpha 1-antitrypsin and ovomucoid (1 mg) diminished significantly the direct plaque forming cell response per spleen 3 days after immunization with 10(8) sheep erythrocytes (SRBC), when given at the same time as the antigen. With alpha 1-antitrypsin, the effect was not significant 4 days after immunization. With soybean inhibitor, no significant suppressive effect was seen, when the inhibitor was given either 24 hours before or after the antigen. Both aprotinin and ovomucoid diminished a secondary response to SRBC, limited to the indirect plaque forming cells. Soybean inhibitor had an equivocal effect on the secondary response. A suppressive effect of soybean inhibitor, but not ovomucoid was seen using KLH-FITC or LPS-FITC as antigens. Neither soybean inhibitor nor aprotinin had an effect on the induction of delayed-type skin reactivity to oxazolone or FITC.

Animals↗
PubMed1981

Endoscopic discovery and capture of Taenia saginata.

The authors report the first case of endoscopic finding and removal of a beef tapeworm (Taenia saginata). The parasite was discovered in the duodenal bulb of a 72-year-old woman, who complained of epigastric pain.

Aged↗
PubMed1980

Villous tumors of the colon and rectum: double-contrast study of 47 cases.

The radiological features of 47 villous tumors of the large bowel found in 39 patients by the double-contrast barium enema were studied. An attempt was made to determine the radiological indicators of malignancy and two features proved to be suspicious: large tumor size and indentation of tumoral base. This retrospective study emphasizes the advantages of the double-contrast technique in the detection of colonic villous tumors.

Adenoma↗