[Exceptional association of bilateral popliteal aneurysm with an abdominal aortic aneurysm in Marfan syndrome]. / Association exceptionnelle d'un anévrysme poplité bilatéral et d'un anévrysme de l'aorte abdominale au cours d'un syndrome de Marfan.

Marfan syndrome is an autosomal dominant disorder with rheumatoid, ophthalmological, neurological, cutaneous and cardiovascular manifestations. Aneurysmal lesions affecting both the abdominal aorta and the peripheral arteries are not often described in the literature. We report a case associating a bilateral popliteal aneurysm and an aneurysm of the infra-renal abdominal aorta.

[Coronary bypass surgery on the beating heart and surgery of an abdominal aortic aneurysm. Immediately sequential surgical treatments]. / Pontages coronaires à coeur battant et anévrisme de l'aorte abdominale. Traitement chirurgical en un temps.

The authors report sequential association during the same general anaesthetic of coronary bypass surgery on the beating heart and surgery of an abdominal aortic aneurysm. Two aorto-coronary bypass grafts were carried out without cardiopulmonary bypass using the two pediculated internal mammary arteries (without manipulation of the ascending aorta), followed, after closure of the chest and monitoring in the operating theatre for one hour, by reinstallation of the patient for treatment of an infra-renal abdominal aortic aneurysm by classical prosthetic implantation. The postoperative course was uncomplicated. Sequential management of coronary revascularisation without cardiopulmonary bypass and aortic aneurysmal lesions during the same anaesthetic provides an alternative to classical two-stage surgery in selected patients.

[Negative emergency laparotomies 1950-1989]. / Laparotomies blanches en urgence, de 1950 à 1989.

In order to list the negative emergency laparotomies, the records of 24,494 laparotomies performed from 1950 to 1989 were examined. 211 negative laparotomies were performed over this 40 years period: 49 for abdominal trauma, 42 for supposed intestinal obstruction, 44 for supposed peritonitis or visceral infection, 46 for presumed early post-operative abdominal complications and 30 for gastrointestinal bleeding. Over these 4 decades, the emergency laparotomy rate and negative laparotomy rate remained stable despite changes in the diagnostic tools, in the age of the patients and the frequency of their diseases.

In situ versus reversed saphenous vein for femoropopliteal bypass: a prospective randomized study of 100 cases.

With the purpose of comparing results using the greater saphenous vein in situ or as a reversed conduit, 100 femoropopliteal bypasses, performed in 91 patients between October 1980 and January 1985, were randomized into two statistically comparable groups of 50 procedures of each type. Seventy-five percent of patients had cutaneous signs of ischemia and 20% had isolated rest pain. Average follow-up was 32 months for the in situ group and 33.4 months in the reversed bypass group. The quality of the vein was statistically better in the in situ group (p less than 0.01). There were six cases of early thrombosis in the in situ group compared to four in the reversed bypass group. In the in situ group, half of the thromboses could be attributed to inadequate valvular destruction. Seven delayed thromboses were noted in the in situ group whereas there were two in the reversed saphenous vein bypass group. The actuarial rates of bypass patency at three years in the reversed and in situ groups were 88.2 and 70.8%, respectively (chi 2 = 2.62; NS). Analysis of results suggests that: 1) the reversed saphenous vein bypass provides excellent results if vein harvest and preparation are as atraumatic as possible; 2) expertise in rendering the valves incompetent markedly increases patency in the in situ technique; 3) during the first 12 months, Doppler follow-up of measured distal pressures is necessary in order to detect pathologic changes of the bypass and adjacent arterial tree.

[Arguments against routine surgery for acute intestinal intussusception. Apropos of 220 cases]. / Plaidoyer contre l'intervention chirurgicale systématique dans les invaginations intestinales aiguës. A propos de 220 observations.

220 children with intussusception were treated at Rouen Children's Hospital between 1969 and 1981. The patients are separated in four groups according to the treatment: --primary operation without barium enema, --operation after failure of the barium enema, --surgical control after reduction by barium enema, --barium enema alone. This study shows that in the third group, the operation did not demonstrate neither any "lead-point", nor any intestinal damage requiring resection. A "lead-point" or an intestinal lesion have been found only in intussusceptions which had not been reduced by barium enema. Thus, one can conclude that a surgical control is useless when the barium enema is successful. The technique of the enema is described.