[Colonic angiodysplasia. Rare cause of low digestive hemorrhage in young patients]. / Angiodysplasie colique. Cause rare d'hémorragie digestive basse du sujet jeune.

We report the following observation of a diffuse kind of colic angiodysplasia in a young subject. Usually to be find in old subjects and regarded as been degenerative origine, angiodysplasiae have been reported in young subjects and we are led to ponder over their nature. The contribution of diagnostic and therapeutic means and their respected place have been specified. In particular the significance of vascular radiology and the angiographic signs of this arterioveinous malformation have been developed.

[Value of colonic irrigation. Long-term followed-up in 432 colostomized patients]. / Intérêt de l'irrigation colique. Suivi à distance de 432 malades colostomisés.

OBJECTIVES: Irrigating colostomies allows patients to achieve nearly complete fecal continence using a simple technique. We assessed long-term results in our series of 432 patients. METHODS: From 1979 to 1992, we followed 432 patients who had undergone definitive colostomy surgery (mean follow-up = 8.4 years). RESULTS: Colonic irrigation was impossible in 281 cases mainly due to retarded patient information (42%) or patient incapacity (31%). It was possible in 151 patients (globally 31%). In patients with abdominoperineal amputations the rate was 63%, for Hartmann procedures 17% and for derivations 6%. Most of the derivations were supraombilical colostomies (n = 51) including 6 who used colonic irrigation. No complications related to the technique were observed and minor incidents (usually problems with the cannula and/or pain) occurred in 61 patients. Thirteen patients (9%) abandoned the technique including 5 who complained of incontinence. CONCLUSIONS: Based on these observations, we conclude that colonic irrigation is not used enough. The key to success is a quality stomy and early patient information and training. This technique is particularly adapted for active patients. It is performed every 48 hours and lasts about 35 minutes.

[Value of the bilio-intestinal bypass in biliary disease in the Far East: retrospective study of 5 year experience at the Calmette Hospital of Phnom Penh (Cambodia)]. / Intérêt de la dérivation bilio-digestive dans la pathologie biliaire Extrême-Orientale: étude rétrospective sur 5 ans à l'Hôpital Calmette de Phnom Penh (Royaume du Cambodge).

Gallstone disease in the Far East exhibits a number of special features regarding epidemiology and etiology as well as indications for and response to surgical treatment. Surgical bypass techniques seldom used for treatment of gallstone disease in the West can be highly effective in lowering complication and recurrence rates in oriental patients. The purpose of this retrospective report is to describe a 5-year experience with gallstone disease at the Calmette Hospital in Phnom Penh (Kingdom of Cambodia). After reviewing the main pathological features encountered, we describe the indications for the two bypass techniques used. Choledocoduodenostomy was used for frail, elderly patients while choledochojejunostomy was the treatment of choice and achieved excellent short, middle, and long-term results in younger patients.

[Microbial overgrowth syndrome after gastrectomy. Recent diagnostic aspects]. / Syndrome de pullulation microbienne après gastrectomie. Aspects diagnostiques récents.

Blind loop syndrome is the most common syndrome of bacterial overgrowth following gastrectomy. We report two cases with diarrhea, steatorrhea, exudative enteropathy and major nutritional deficiency. Diagnosis was based on the breath test and aspirate analysis. Surgery with restoration of the duodenal continuity was the treatment. Patients with contraindications for surgery should be given prolonged antibiotic therapy which should be repeated if symptoms reoccur.

The 1986 terrorist bombing experience in Paris.

Between December 7, 1985 and September 17, 1986, eleven terrorist bomb explosions took place in Paris. Thirteen people died immediately, 255 others were injured. Forty were treated on-site and were not hospitalized, 205 were subjected to triage and stabilization and were then hospitalized. These latter 205 patients are analyzed in this study. None of them died during transportation, and seven eventually died in hospitals. Forty-seven per cent of all victims suffered from multiple injuries. All deaths except one occurred in the polytraumatized group. The policy of subjecting victims of terrorist bomb explosions to triage and stabilization before hospitalization is compared to the so-called "scoop and run" technique, more generally applied in mass casualty situations. Its limitations and advantages are discussed.