Journal de chirurgie
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Journal de chirurgie · Oct 1990
Review Case Reports[Post-traumatic hemobilia caused by arteriobiliary fistula. A case report and review of the literature].
One new case of post-traumatic hematobilia due to an arteriobilary fistula is reported. This etiology is relatively rare, and its diagnosis is sometimes difficult if the three signs: pain, bleeding and jaundice are not observed. The most effective paraclinical examination still is selective arteriogrpahy, which makes the diagnosis possible, accurately locates the fistula and sometimes allows hyperselective embolization, as it did in this case. The use of embolization for the treatment of post-traumatic hematobilia due to an arteriobiliary fistula reduces operative mortality for this disease, which still has a poor prognosis.
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Endosonography consists of exploring the gastrointestinal wall and surrounding tissue with the aid of an ultrasound transducer introduced into the gastrointestinal lumen. High frequency ultrasound (more than 7 MHz) is used and provides high definition imaging. Its principal role is in oncology, and more particularly in the assessment of tumor extension. ⋯ Endosonography provides better analysis of lymph nodes than CT scan (70 to 75% precision) and improvements will occur with better description of the criteria of malignancy. It appears interesting for the evaluation of pancreatic and biliary tumors and for follow-up of patients already treated for gastrointestinal cancer. Among its other indications, some have been well established (gastrointestinal submucosal tumors, giant gastropathy) and others require confirmation (villous tumors of the rectum, gastric ulcer).
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Journal de chirurgie · Mar 1988
Review Case Reports[Reexpansion pulmonary edema after pneumothorax. Apropos of a case. Review of the literature].
Pulmonary edema after re-expansion of a pneumothorax occurs within a maximum of 3 days of the pneumothorax and manifests by intense clinical signs (cough, abundant foamy expectoration, major cyanosis), marked hypoxia and a "white lung" radiologic image. The outcome was rapidly favorable in the case reported, despite the severity of the initial symptomatology. ⋯ A hemodynamic edema also exists as a consequence of the reduction in pulmonary interstitial pressure. Possible prophylactic measures are discussed, the most appropriate appearing to be very progressive evacuation of the pneumothorax.
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The authors report a personal case of spontaneous rupture of the splenic vein during pregnancy, already published elsewhere [6], and study again spontaneous rupture of the splenic vessels, artery or vein, and rupture of the spleen in relation to pregnancy, either during or after labour. In all, 150 cases were found in the world literature. ⋯ Splenectomy remains, in all cases, the basis of surgical treatment. In cases of maternal survival, the late, general and obstetric prognosis remains good.