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Biomedical subjects

R Pierrugues

Publications and source records attributed to R Pierrugues.

24 records · Page 2Linked to original sources

[Pancreatic pseudo-tumor caused by bilio-pancreatic tuberculous lymphadenitis. 2 cases].

Peripancreatic tuberculous lymphadenitis is rare and of difficult diagnosis. The two cases described illustrate two clinical aspects according to the proximity of the biliary tract: either anterior lymph nodes responsible for obstructive jaundice, or posterior lymph nodes responsible for chronic epigastric pain. Endoscopic retrograde cholangiopancreatography is essential to exclude a pancreatic lesion and facilitate the interpretation of the CT images. Tuberculosis must then be suspected. In the absence of another tuberculous localisation, laparotomy is necessary to assert the diagnosis. Antituberculous chemotherapy alone, administered for 9 to 12 months, cures this form of tuberculous lymphadenitis.

Cholangiopancreatography, Endoscopic Retrograde↗

Relationship of resting energy expenditure with liver function and nutritional status in patients with alcoholic cirrhosis.

Resting energy expenditures (REEs) were measured in 40 alcoholic cirrhotic (AC) patients by indirect calorimetry and corrected for 24-h urinary creatinine and excretion. These REEs were compared according to the stage of severity of the cirrhosis, the nutritional status, and the presence or absence of alcoholic hepatitis (AH). Mean REE was not significantly different between the Child class A, B, and C patients, even when corrected for 24-h urinary creatinine. Mean REE was significantly less in malnourished AC than in well-nourished patients (1308 +/- 285 vs. 1531 +/- 255 kcal, p less than 0.02). However, when measured energy expenditure was corrected for 24-h urinary creatinine, the difference between the two groups of patients disappeared (1800 +/- 540 kcal/g creatinine in malnourished patients vs. 1890 +/- 780 kcal/g creatinine in well-nourished patients). Finally, there was no significant difference between the REE, corrected or not, for the 24-h urinary creatinine in AC with or without AH. Thus, when REE is normalized to lean body mass, represented by 24-h urinary creatinine, the metabolic activity in AC is not dependent on the severity of the cirrhosis, nutritional status, or existence of AH.

Adult↗

[Dyspepsia and Helicobacter (Campylobacter) pylori. Results of a randomized therapeutic trial using amoxicillin versus placebos].

A population of non ulcer dyspepsia outpatients with a normal gastroscopy was assessed. Clinical complaints, the type of the gastritis, its activity and bacterial density were evaluated. Helicobacter pylori (HP) was sought by histology, urease test and culture, on 3 distinct locations. HP was found in 62 p. cent of the patients, always in association with gastritis. Urease test and histology had the same sensitivity in the detection of HP. A randomized double blind study with amoxicillin vs placebo was carried out in 23 patients. At the end of 4 week treatment, a gastroscopy with biopsies was performed. The amoxicillin treated patients were significantly cured or improved. HP was undetectable or the bacterial density was decreased in this group. After amoxicillin, urease test was more sensitive than histology. HP might be involved in the pathophysiology of non ulcer dyspepsia in patients where HP was found.

Adult↗

[Cyriax's syndrome. A cause of diagnostic error in abdominal pains].

The slipping rib syndrome is characterized by upper abdominal pain due to irritation of the intercostal nerve by incomplete dislocation of the costal cartilage of the 8th, 9th, or 10th ribs. Twenty-three new cases are reported and the literature is reviewed. Diagnosis is only clinical. The pain is precipitated by movement and certain postures; it is faithfully reproduced by pressure on one particular point of the costal margin and is relieved by local injection of an anaesthetic. Pain from a slipping rib is usually attributed to visceral causes, which is a source of diagnostic errors.

Abdomen↗