[Dilatation of bile ducts in polycystic kidney disease in adults]. / Dilatation des voies biliaires au cours de la polykystose rénale de l'adulte.

We report the cases of 4 adult patients with polycystic kidney disease and dilatation of bile ducts. Dilatation involved the extra-hepatic bile ducts in all 4 cases and also affected the intra-hepatic bile ducts in 3 cases. A prospective ultrasonographic study in search of biliary tract abnormalities was undertaken in 40 patients with dominant polycystic kidney disease. No bile duct dilatation was found in this series, which indicates that the lesion is rare. The 4 cases reported here increase the collection of hepatobiliary lesions associated with polycystic kidney disease of adults.

[Echography in pyelocaliceal tumors]. / L'échographie dans les tumeurs pyélo-calicielles.

In a study of over 32 pyelocaliceal tumors greater than 1 cm in diameter, the authors review retrospectively the reports of the pyelographic and sonographic documents obtained in these patients before the definitive diagnosis was confirmed by the pathological examination. They observed that pyelography has a much greater diagnostic accuracy than does sonography: 31 confirmed (27) or suspected (4) tumors whereas only one tumor was overlooked (silent kidney) on pyelography and 12 diagnosed tumors, 15 overlooked and 5 diagnostic errors on ultrasonography. However, it should be noted that the results of ultrasonography are much better when the results of the intravenous pyelogram are known than when the latter is performed first. These results are supported by triple-blind re-reading of ultrasonographic documents of tumors of the excretory tract grouped with documents of normal kidneys presenting another disease of the sinus. The authors conclude that ultrasonography must be performed first whenever a tumor of the excretory tract is suspected (especially in case of hematuria) and that in this field, there are essentially two indications for ultrasonography: --To remove a stone (hyperechogenic with a cone of shadow) if there is a pyelocaliceal lacuna of unknown cause. --To establish that obstruction is due to a tumor, in the presence of a silent kidney.

[Imaging of ureteral and pelvic diverticuli. Apropos of 49 cases]. / Les images diverticulaires de l'uretère et du bassinet. A propos de 49 cas.

A review of 49 cases of rare ureteral and pelvic diverticula enables certain clinical and radiologic conclusions to be drawn. Lesions were bifid ureters with blind branches (20 cases), single (8 cases) or multiple (10 cases) diverticula of ureter and pelvic diverticula (11 cases). As previously reported, ureteral diverticula produced few clinical signs whereas these were marked in pyelic lesions. Multiple diverticula are particularly difficult to detect, but diagnosis is the rule from radiologic appearances and is generally confirmed by results of therapy. Their pathogenesis is poorly understood, however, mainly due to lack of histologic data, but recent studies by Cochran suggest they are a particular from of ureteritis. The only debatable point is the frequent association of multiple diverticula with bladder tumor, described by Cochran and confirmed by the authors and unlikely to be the result of chance. Further studies are necessary to provide clarification.

[Cystic pyeloureteritis. Apropos of 40 cases]. / La pyélo-urétérite kystique. A propos de 40 cas.

A series of 40 cases of cystic pyeloureteritis (CPU) is reported, this affection being considered as rare since only about 150 cases have been described in the literature. The lesion is probably more prevalent than was once believed but many cases probably remain unrecognized because of the paucity of radiologic signs. Based on findings in these 40 patients, results of radiologic imaging are described, the technical precautions needed for its detection emphasized and differential diagnoses discussed, none of which presents insurmountable obstacles since these are more theoretical than real. Pathogenesis is thought to be an acquired particular form of urinary mucosa metaplasia associated with urinary tract lesions responsible for stasis or chronic inflammation. Treatment should be conservative because of the usual benign nature of the lesion, although exceptional but possible occlusion by the lesions necessitates a certain surveillance.

[Value of x-ray computed tomography in the diagnosis and surveillance of abdominopelvic recurrence of cancers of the uterine cervix. Apropos of 38 cases]. / Intérêt de la tomodensitométrie dans le diagnostic et la surveillance des récidives abdomino pelviennes des cancers du col utérin. A propos de 38 observations.

A retrospective study was conducted involving all case reports of patients treated for uterine cervix cancer, and investigated by a CT scan for suspected or follow up of a recurrence between Jan. 1981 and Nov. 1982. CT scan findings are described and the value of the method assessed; it appears to be very effective for diagnosis of recurrence in lumbar aortic lymph nodes, since it was the only examination enabling positive diagnosis in 13 out of 15 cases. Its diagnosis value is less in pelvic tumor recurrence, directly accessible to clinical examination (3 diagnoses only out of 9 cases). The CT scan is a reliable exploratory procedure since only 4 examinations were normal of the 38 completed. Possible therapeutic applications are discussed.

[Intrahepatic localization of a pancreatic pseudocyst]. / Localisation intra-hépatique d'un faux kyste du pancréas.

Intrahepatic false cysts of the pancreas are rarely observed, and only 5 cases have been reported in the published literature since 1965. Recent publications concerning false cysts located adjacent to or within abdominal parenchymas are reviewed. The most common sites are renal and splenic. Radiologic images usually simulate an intravisceral tumoral lesion, even when the false cyst is in contact only with the parenchyma, because of inflammatory changes. Diagnosis depends on complete radiographic exploration of the pancreas, including ultrasonography, a CT scan, and coeliomesenteric arteriography if possible, to detect possible signs of pancreatitis. Ultrasound guided cyst puncture is of marked diagnostic and possible therapeutic value.

[Osteogenesis imperfecta and aortic incompetence. One case with pathological findings. Review of the literature (author's transl)]. / Ostéogenèse imparfaite et insuffisance aortique. Une observation avec documents anatomiques. Revue de la littérature.

Cardiovascular manifestations of Lobstein's disease are rare, probably unrecognized, and determining factors for the final prognosis, the most frequent lesion being aortic incompetence. The eleventh case to be reported with pathological findings in the literature is described. This complication is usually found in men, blood regurgitation being large in amount, symptomatic, and progressive. Its mechanism is related less to dilatation of the aorta and its ring than to valvular changes, they being frequently bicuspid and dysplasic. Histological findings, not however pathognomonic, are myxoid degeneration in the valves and parietal cystic necrosis in the aortic wall. Apart from the absence of an aneurysm and aortic dissection, macro- and microscopic lesions are similar to those observed in Marfan's syndrome and osteogenesis imperfecta. Operative therapy was employed in all eleven cases, with three postoperative deaths and three later deaths. Certain complications arise from uncontrollable severe hemorrhage, which justifies the use of valve heterografts not requiring antivitamin K administration.