[Radiation protection of operators during endoscopic retrograde cholangiopancreatography]. / Radioprotection des opérateurs lors des cholangio-pancréatographies rétrogrades endoscopiques.

Radiation hazards to operators performing retrograde endoscopic cholangio-pancreatographies (RECP) have been investigated. The principles and central elements of French medical radioprotection legislation are recalled. Doses received by the operators, over a one month period representative of their usual work, were measured in two ways: by using a ionisation chamber and with thermoluminescent detectors worn by the staff. Extrapolated to 12 months, the results were inferior to the annual reglementary dose limit: whole body < 1.2 mSv (against 50 mSv), eye lens = 38.4 mSv (against 150 mSv). Further means for reducing dose levels are proposed.

[Portal vein thrombosis and hereditary protein C deficiency. Presentation of a case and review of the literature]. / Thrombose portale et déficit héréditaire en protéine C. Présentation d'un cas et revue de la littérature.

The authors report the case of a 51 year-old man, without any personal or familial history of thromboembolism, presenting with abdominal pain. Portal vein thrombosis was demonstrated by ultrasonography and arteriography. The patient had neither esophageal varices or congestive gastropathy. No cause for portal vein thrombosis was detected. Type I protein C deficiency was demonstrated in this patient as well as in his asymptomatic sister. The presence of a (fortuitously?) associated increase in platelet aggregability initially led to a trial regimen of aspirin (300 mg per day); abdominal pain resolved, and a partial regression of portal vein thrombosis was demonstrated on ultrasonograms six months later; no further complications occurred during the 4-year follow-up period. The 13 previously published cases of protein C deficiency-associated portal vein thrombosis are reviewed.

[Asymptomatic cystic dilatation of the choledochus in an adult]. / Dilatation kystique asymptomatique du cholédoque chez un adulte.

A congenital choledochal cyst, type Ia according to Todani's classification, was discovered fortuitously in a 54-year old man by abdominal sonography. The patient had no biliary symptoms, and liver tests were normal. Excision of the cyst was performed because of the theoretical risk of cholangiocarcinoma. Recovery was uneventful.

[Double paraneoplastic syndrome and anaplastic carcinoma of the lung. ADH and ACTH levels in the tumoral tissue (author's transl)]. / Double syndrome paranéoplasique au cours d'un carcinome anaplasique du poumon. Dosage de l'ADH et de l'ACTH dans le tissu tumoral.

A double paraneoplasic syndrome with hypersecretion of ADH and ACTH revealed the presence of a small cell bronchial cancer in a man aged 62 years. Water and electrolyte anomalies due to the hypersecretions were of such a degree that an occlusive syndrome occurred. Very high levels of ADH and ACTH were found in the tumoral tissue. The measurement of these levels is rarely conducted at the present time but was able to define the mechanism of abnormal secretion of these two hormones in this case.