Annales de chirurgie
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Annales de chirurgie · Jan 1998
Review Comparative Study[Diagnostic strategy in abdominal injuries].
There is persistent controversy concerning the management of patients with abdominal trauma. The major point is to determine whether or not the abdominal trauma is penetrating. ⋯ In the case of anterior penetrating abdominal trauma, diagnostic peritoneal lavage, which is an over sensitive method, could be replaced by laparoscopy, which allows both diagnosis and treatment. Triple-contrast CT scan is the first-line diagnostic modality in penetrating back and flank trauma.
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Annales de chirurgie · Jan 1998
Review Case Reports[Value of celioscopy in treatment of isolated torsion of the Fallopian tube. Review of the literature. Apropos of 3 cases].
Isolated fallopian tube torsion (ITT) is infrequent and associated with morphologic and dynamic disturbances. Mr L, 31 years old, suffered from right lower quadrant pain which became worse during the following 48 hours. Laparoscopy revealed a right necrotic ITT which was resected by laparotomy. ⋯ Diagnosis was easily established by laparoscopy. In case of clinical symptoms suggestive of ITT, pelvic and endovaginal ultrasonography and laparoscopy are indicated. Tubal preservation must be the rule.
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Annales de chirurgie · Jan 1998
Review Case Reports[Pleuro-peritoneal Denver shunt in treatment of chronic pleurisy].
The first utilisation in our hospital of a pleuraperitoneal shunt for the treatment of chronic pleurisy enabled us to study, in the light of published data, the place for such a procedure in the management of resistant pleural effusion. The aetiology of the pleurisy in a 70-year old patient who underwent this mini-invasive surgery was unknown when the shunt was inserted, but his symtoms clearly improved afterwards. At the present time with a follow-up of 13 months, there are no local complications and the system is in good working order. ⋯ A complication rate of 25% is noted depending on the type of infection or obstruction leading to replacement of the shunt. No case of erosion has been noted. The long term patency, measured by radio-isotope injections (Tc99m), has not been studied but there is a significant reduction in the length of hospital stay which gives a clear economic advantage to such procedures.