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Biomedical subjects

Y Heloury

Publications and source records attributed to Y Heloury.

61 records · Page 4Linked to original sources

[Meckel's diverticulum. Is it necessary to search for it? Is it necessary to remove it? Apropos of 116 cases].

Of 116 Meckel's diverticula operated upon over a period of 13 years, 35 had provoked severe disorders and 80 p. cent of the cases concerned patients under 30 years of age. Occlusions represented half of the lesions involved, perforations, hemorrhages, and diverticulitis being less frequently involved. Mucosal heterotopia was a relatively frequent finding: 13 p. cent of cases, and was often the origin of hemorrhagic accidents. Asymptomatic diverticula can be potentially pathologic, as 2 carcinoid tumors and 2 cases of gastric heterotopia were discovered during routine examinations, suggesting that prophylactic excision of apparently healthy diverticula should be performed in young subjects.

Adolescent↗

[Complications of appendicitis and appendectomies. Apropos of 106 cases].

Analysis of 106 case-reports of patients developing complications after appendicectomy provided data on factors predisposing to these sequelae (general condition, initial appendicitis) and their severity (26 deaths equivalent to 24,5 p. cent). Complications were exclusively medical in 22 patients (12 deaths), or surgical in 48 cases (no deaths), and were multiple and/or mixed surgical sequelae in 36 patients (14 deaths). The severity of these medical and surgical complications is emphasized and their appropriate treatment proposed. Statistical analysis of findings in patients with several complications enabled definition of risk factors: peritonitis, septic shock, renal or respiratory insufficiency, age over 50 years, and previous history of disease. Analysis of these risk factors, whether multiple or associated with other complications, can be used for numerical rating of prognosis in these patients.

Abscess↗

[Anatomical considerations on the approach to the subdiaphragmatic aorta].

The surgical approach to the supra coeliac aorta, after cutting muscular fibers surrounding the oesophageal hiatus has been, recently, suggested. Herein we study the structure of the hiatus in order to estimate the ease of that way. The oesophageal hiatus if formed in 60% of the cases to the detriment of the right pillar only. Thus the anterior wall of the lower part of the thoracic aorta can be exposed by cutting the deep fascicle only; in the other cases (40%), some crossed fibers from the left pillar participate to the constitution of oesophageal hiatus; these crossed fibers have to be cut but are of reduced volume. The abdominal approach of the lower part of the thoracic aorta seems to be interesting technical solution.

Aorta↗

[Acquired phimosis, or preputial sclero-atrophic lichen in children].

From 1979 to 1988, 8 cases of balanitis xerotica obliterans were histologically demonstrated in children at Nantes University Hospital. In 6 of these 8 patients, whose average age at the time of consultation was 9.4 years, the phimosis was obviously acquired or recurrent, and the prepuce was sclerous, thick, and produced a tight distal phimosis. One child coming to consultation for relapsing urinary infections at once presented with a long, tight stenosis of the anterior ureter, associated with a dilatation of the upstream ureter and a filiform stream of urine. All the children were circumcised, and the histological study of the specimen demonstrated characteristic lesions in the superficial derma. During the same operation, meatostomy was performed in two children presenting with meatal stenosis. Six of 8 children were followed up with an average time lapse of 6 months: one of them presented with an involvement of the glans penis and a moderate meatal stenosis, which disappeared spontaneously. No improvement occurred for the child presenting with an extensive stenosis of the anterior ureter, in spite of the local instillation of androgens then of corticoids, but his left kidney was dilated on sonograms. Balanitis xerotica obliterans in children is often not recognized and regarded as a common phimosis; it can be suspected because of the clinical features of the phimosis. The condition must be confirmed by the histological study of a circumcision specimen, then followed up regularly to prevent any risk of involvement of the glans, of the ureteral meatus or of the anterior ureter.

Adolescent↗

[Organization of emergency pediatric surgery at the University Hospital in Nantes].

A special emergency ward for paediatric patients was established at the University Hospital in Nantes on November 7, 1990. Both medical and surgical patients less than 15 years, 3 months of age are admitted. The initial organization of the ward (facilities personnel, on call duty) are described for the emergency paediatric surgery unit. The activity of the unit over a 4 month period (from June to September 1992) was retrospectively examined. During this period, 4,438 children were referred to the emergency ward and 2,905 (64.8%) involved a surgical pathology. The epidemiological characteristics of the patients (age, geographic origin, day and hour of admission), the causal pathology, the examinations and procedures performed, and outcome (length of stay in the ward long-term outcome) were studied. Based on these results, the authors analyzed the factors leading to dysfunction and proposed improvements in the organization of this emergency ward.

Adolescent↗