[Congenital hepatic fibrosis. Five cases with late occurrence in adults]. / Fibrose hépatique congénitale. Cinq cas à révélation tardive chez l'adulte.

Congenital hepatic fibrosis (CHF), is an autosomal recessive disease, presenting principally in childhood with portal hypertension and/or cholangitis, and often associated with renal malformations. The forms presenting later in adults are rare, and illustrated herein by 4 cases with dominant cholangitis, and one latent form. Biological tests and radiological imaging are often normal. The histopathologic diagnosis, sometimes difficult on liver needle biopsy is based on fibrous enlargement of portal areas, with numerous and tortuous bile ducts, lined by regular, cuboidal epithelium. Interportal fibrosis can mimic cirrhosis. In CHF, cholangitis are favoured by intrahepatic biliary dilatation, sometimes related to Caroli's disease, associated in 25% of cases. Suppurative complications, sometimes fatal explain the severity of cholangitis forms of CHF, contraindicating inopportune cholangiography and biliary surgery.

[The surgical treatment of liver metastasis of carcinoid tumors]. / Le traitement chirurgical des métastases hépatiques des tumeurs carcinoïdes.

Liver metastasis of carcinoid tumors from the digestive tract are rare entities, with characteristic symptoms and slow evolution. Symptomatic metastases may justify surgical resection. Herein, we report a series of nine patients, who underwent 14 hepatic resections (6 major and 8 minor), which was radically operated in 71%. The postoperative mortality was zero and the morbidity was 7%. Mean follow-up was 82 month (median 75 months) and global survival rate was 89%. Two patients are in complete remission. Our experience suggest that surgical hepatic resection, when feasible, is efficient and associated with prolonged survival despite a high recurrence rate.

[Cystic dystrophy in heterotopic pancreas of the second part of the duodenum. One case of conservative surgical procedure]. / Dystrophie kystique du deuxième duodénum sur pancréas aberrant. Un cas de traitement chirurgical conservateur.

Duodenal cystic dystrophy due to ectopic pancreas deposit is an uncommon pathology. Diagnosis is made by modern imaging techniques, mainly endoscopic ultrasound which localizes precisely cysts in duodenal wall. The most frequent clinical symptoms are pain, duodenal obstruction, and weight loss. We report the case of a 40 year-old man with cystic dystrophy of the 2nd part of the duodenum, without chronic pancreatitis, treated by a conservative surgical procedure including segmental duodenal resection. This original approach is an alternative to the Whipple procedure.

[Treatment of large abdominal eventrations with an intraperitoneal stapled plate. Apropos of a series of 27 patients]. / Traitement des grandes éventrations abdominales par plaque intra-péritonéale agrafée. A propos d'une série de vingt-sept patients.

Treatment of 27 large abdominal eventrations by intra-peritoneal prothesis fixed by staples is reported. Only one recurrence (3.5%) in the post-operative period, the good results observed, absence of grave complication, and great simplicity of this procedure lead the authors to recommend the use of intraperitoneal prosthesis in the treatment of post-operative eventration with major loss of parietal substance.

[Treatment of endoscopic colonic perforations by anastomosis in non exclusive lateral colostomy]. / Traitement des perforations coliques endoscopiques par abouchement à la peau en colostomie latérale non excluante.

The authors report two cases of colonic endoscopic perforation with peritonitis treated by minimal lateral colostomy. The evolution was favorable in this two cases with spontaneous closure of colostomy. We intended to remind the usefulness of this old and simple technique sometimes omitted in the therapeutic armentorium of the iatrogenic colic perforation, especially from endoscopic origin. Thus the risk of complications of an ideal surgery or the necessity of a second-time anastomosis after the initial colostomy can be avoided.

Comparison of Bender-Gestalt and WISC correlations for Puerto Rican, White and Negro children.

Correlations between Bender-Gestalt scores and WISC IQs were obtained for three ethnic groups of 123 Puerto Rican, 82 white, and 61 Negro children in the first grade. The Bender-Gestalt test did not show any significant relationship with the WISC scores of the Puerto Rican children. Significant correlations (p less than .01) between the Bender and all the WISC scores were found for the Negro group. For the white Ss, the WISC-Bender relationship was significant (p less than .01) only for the Performance and Full Scale scores. The absence of a significant correlation between the Bender and the WISC Verbal IQ in these children was attributed to the relative superiority of their Verbal scores.

Aneurysms of the infrapopliteal arteries.

Atherosclerotic aneurysms involving only infrapopliteal arteries are extremely rare. The present report describes a patient with two completely separate aneurysmal dilatations involving the tibioperoneal trunk and the anterior tibial artery. To our knowledge, this condition has not been previously described. An international bibliographic review was also made, collecting four patients affected by atherosclerotic infrapopliteal aneurysms. Clinical presentation, radiographic findings, and surgical management are discussed.

Diagnosis of popliteal artery entrapment syndrome: the role of duplex scanning.

The authors present a new diagnostic procedure to quickly and noninvasively diagnose the popliteal artery entrapment syndrome. A large personal experience on the surgical treatment of such a disease (29 cases in 22 patients) allowed us to focus on the optimal diagnostic procedure useful to detect this problem at an early stage. The technique is based on continuous-wave Doppler and duplex scanning studies done both in the resting state and during active contraction of the calf muscles. If compression of the popliteal artery occurs with contraction of the calf muscles, it will be detected by a decrease in flow. This finding will also direct the radiologist to obtain films when the maneuver is repeated. This makes it unlikely that the diagnosis will be missed. Since July 1988 a total of 1212 patients were evaluated with continuous-wave Doppler for suspected chronic ischemia. From this group 41 patients were selected to be studied again with the combined continuous-wave Doppler and duplex scanning method for possible popliteal artery entrapment syndrome. Two cases were discovered and verified by dynamic angiography guided by continuous-wave Doppler and treated surgically.