A new sphincter-splitting operation for surgical access to low-lying tumors of the rectum.

Fifty-eight patients underwent anterior anorectotomy for removal of intrarectal tumor. The mean age of patients was 69 years: 33 were over 70.26 tumors were benign and 32 malignant. There were no postoperative deaths during hospital stay or the 30 days following discharge. Six abscesses and 2 self-limiting urethral fistulas were diagnosed in 2 male patients. The wound healed at day 14 on the average. Sphincter function was judged to be poor or average in 2 cases each and normal in the remaining 54. One patient had local recurrence at 6 years, amenable to reoperation. Five patients died of their cancer between 10 months and 2 years. Anterior anorectotomy permits exposition up to 14 cm from the anal verge, is not mutilating, can be performed under spinal anesthesia, and is recommended for removal of benign rectal tumors as well as small carcinomas in patients physically or mentally unfit for major abdominal surgery.

[Needle catheter jejunostomy. An improved technique for enteral feeding (author's transl)]. / Jéjunostomie intramurale á l'aiguille. Technique a minima pour l'alimentation entérale.

The authors have perfected the method of needle catheter jejunostomy introduced in 1973 for enteral feeding. Using the Seldinger technique reduces the risks of leakage, intra-operative haematoma and fistula following removal of the catheter. The operative procedure is described and the preliminary results are reported.

[Perforated appendix associated with inflammatory ileo-coecal pseudotumour (malacoplakia) (author's transl)]. / Perforation appendiculaire associée à une pseudo-tumeur inflammatoire malacoplasique.

The authors report one case of perforated appendix associated with an inflammatory ileo-coecal pseudotumour due to malacoplakia. Right hemicolectomy resulted in uneventful and complete recovery. This case, together with a survey of available published data, enables the authors to briefly review the pathological, pathogenic and therapeutic aspects of this rare, if not exceptional, localisation of malacoplakia.

[Lipoma of the small intestine revealed by ileocaecal intussusception (author's transl)]. / Lipome de la dernière anse grêle révélé par une invagination intestinale aiguë.

The authors report a personal case of ileocaecal intussusception in an adult, revealing a benign lipoma of the last ileal loop. A review of the available bibliography was made emphasizing the essential characteristics of this rare type of lesion.

[Inflammatory pseudo-tumors of appendiceal origin. Study of twelve cases (author's transl)]. / Pseudo-tumeurs inflammatoires d'origine appendiculaire. Etude de 12 cas.

The authors relate their experience concerning twelve cases of inflammatory pseudo-tumors of appendiceal origin treated during the last five years. Their personal acquisitions are confronted with the literature and they propose a protocole of clinical, roentgenological and intra-operatory diagnosis thus permitting rational and adapted management.

[The repair of large abdominal dehiscences by anchored mersilene plates (author's transl)]. / Cure des grandes éventrations abdominales par plaque de mersilène haubannée.

We propose a new technique for repair of abdominal ventral eventration, using a large mersilene mesh prothesis which is sutured to the anterior pelvic ridge below (Cooper's ligament and the dorsal aspect of the conjoint tendon) and to the intra-abdominal aspect of the ventral abdominal wall above, by means of three sub-costal attachments which have been compared to boat shrouds. This prostetic sheet therefore runs through two distinct anatomical spaces and is fixed to the abdominal wall all along its periphery.

[Microangiopathic anaemia with thrombocytopaenia. Cure following excision of an angioma of the small intestine (author's transl)]. / Anémie microangiopathique avec thrombopénie. Guérison par ablation d'un angiome du grêle.

The association of a mixed anaemia (by occult haemorrhage and microangiopathic haemolysis) with a thrombocytopaenia led to a search for a digestive angioma. Arteriography, followed by exploratory laparotomy with preoperative enteroscopy and frozen section histological examination, led to the discovery of a small bowel angioma (multiple phlebectasias) which was partially resected. A review of the literature emphasised the rarity of intestinal angiomas with thrombocytopaenia (Kasabach and Merrit syndrome) and forms a basis for the discussion of haematological abnormalities (intravascular coagulation, microangiopathic anaemia) which may be induced by such vascular malformations.