[Influence of surgical biliary pathology on the diffusion of ceftriaxone in the biliary tract]. / Influence de la pathologie biliaire chirurgicale sur la diffusion de la ceftriaxone dans l'arbre biliaire.

Ceftriaxone is a third generation cephalosporin remarkable for its wide distribution in the biliary tract. The purpose of this study was to determine whether biliary tract pathology, as observed during surgery, had an influence on this distribution. 52 patients about to be operated upon and presenting with a high risk of bile infection received a single 1 or 2 g dose of ceftriaxone administered intravenously over 20 min during the hour that preceded surgery. Samples of blood and of bile from the gallbladder (GB) and the common bile duct (CBD), as well as specimens of the GB wall were taken during the operation. In patients whose GB was normal at laparotomy (apart from stones) ceftriaxone concentrations in bile and GB wall were 10-25 and 2 times respectively higher than in plasma. In patients with a grossly distended but not infected GB (hydrocholecystis) ceftriaxone levels were high in CBD bile but null in GB bile and only one-quarter to one-half of plasma levels in GB wall. In patients with stones in the CBD or inflamed GB wall ceftriaxone levels were high in bile (although lower than in cases with normal GB) and similar to plasma levels in GB wall. When malignant pancreatic lesions were present ceftriaxone concentrations could not be measured in both GB and CBD bile but reached 50% of plasma concentrations in GB wall.(ABSTRACT TRUNCATED AT 250 WORDS)

[Diagnostic value of arteriography in a case of splenomegaly of unknown origin (author's transl)]. / Apport de l'artériographie dans un cas de splénomégalie inexpliquée.

A 32 year-old patient was found to have a tender enlarged spleen with hardly any other signs apart from transient fever and moderate hepatomegaly. Coeliac arteriography was performed to eliminate the possibility of a splenic tumor. The splenic arteriography showed the presence of a great number of lacuna dispersed throughout the parenchyma and measuring 0,5 to 1 cm. Histopathological examination of samples of the spleen, removed by operation, and biopsies of the liver and lymphnodes confirmed the diagnosis of sarcoidosis of the liver, spleen and lymphnodes.

[Epidermoid cyst of the spleen]. / Kyste épidermoïde splénique.

Epidermoid cysts rarely occur in the spleen and are often found fortuitously. Epidermoid cyst of the spleen is an inclusion of epidermoid elements within a mesodermic structure. Treatment is partial conservative splenectomy followed by ultrasound surveillance.