Journal de chirurgie
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Journal de chirurgie · Dec 1997
Case Reports[False radiologic pneumoperitoneum. The value of emergency abdominal computed tomography].
We report 2 cases of false pneumoperitoneum. The diagnosis was suspected on an upright chest or abdominal plain films. ⋯ Emergency CT scan definitely eliminated a pneumoperitoneum and suggested the right diagnosis in both cases. This exam may play the decisive role in preventing needless emergency laparotomy.
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Journal de chirurgie · Sep 1997
Review[Firearm wounds of the lower urinary tract in men. Surgical management in emergency context].
The lower urinary tract is injured in less than 1% of all firearm wounds in men. In war medicine, blast wounds occur in 75% of the cases while in civil medicine ballistic injuries are more frequent. When the bladder and the posterior urethra is involved, the projectile usually follows a path through the gluteal muscles and pelvis. ⋯ Associated wounds involving the anus and rectum require colostomy, emptying the excluded rectum and wide pelvic-perineal drainage. An attempt should be made to repair the rectum or the sphincter. Genital lesions require early repair: tight suture of the albuginea of the cavernous bodies with or without a patch, preservation of viable testicular parenchyma and adnexal tissues (but orchidectomy is necessary in 50% of the cases).
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All patients with cancer invariably experience pain during the course of their disease. Treatment- and diagnosis-related acute pain and persistent pain caused by the disease itself or treatment sequellae are involved. Pain should be suspected, diagnosed and evaluated as a first line symptom. ⋯ Treatment should be prescribed according to the needs of each patient and regularly verified to obtain maximal efficacity with the least side effects. Opiate drugs are frequently used for nocipeptive pain. Neurogenic pain requires selective use of psychotropes.
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Journal de chirurgie · Jun 1996
[Significant value and therapeutic implications of routine gastroscopy before cholecystectomy].
Endoscopy of the upper digestive tract was performed in 338 consecutive patients undergoing cholecystectomy between January 1991 and December 1992. Pathological findings were seen in 160 (47.3%), 6.8% of the patients had peptic ulcers, 1.8% gastric erosions, 25.7% gastritis, 3.2% polyps, 4.7% hiatal hernias, 3.0% oesophagitis and 0.6% gastric cancer. ⋯ Two patients with gastric cancer underwent gastrectomy. These results underline the importance of a routine gastroscopy before elective cholecystectomy.