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On the basis of a comparative study of 100 angiograms, the authors stress the value of photographic substraction in gastrointestinal angiography. From a technical viewpoint, after a brief review of the theoretical background, the authors emphasise the need to use reproductions of different tonality, and the problems of blurring due to movement, which may be overcome by the use of an effective premedication (diazepam) and by limiting the substraction to a very limited arca. From the standpoint of results, photographic substraction gives improved radiological data in the arterial phase in 60% of cases. This improvement concerns the prevertebral vessels. During the venous phase, in all cases there is an improvement in mesenterico-portal return and the visualisation of oesophageal varices. In all, photographic substraction, a simple technique, appears to be of value in gastrointestinal angiography essentially in the arteriographic study of the pancreas and of spleno-portal and mesenterico-portal venous return.

Renal angioplasty was performed in twenty hypertensive patients, and good immediate results were obtained in 18 cases. One unsuccessful result was due to insufficient dilatation of a stenosed renal artery, and another from an accident during dissection of the aortic wall in contact with the renal ostium. Repeated dilatation was necessary in two cases following recurrence of stenosis. A high percentage improvement in the hypertension was obtained: 12 cases recovered and there was marked improvement in 4 other patients, treatment being effective, therefore, in 16 of the 20 patients operated upon. The published literature is reviewed, and emphasis placed on the need for treatment by surgeons experienced in angiography examinations, in close collaboration with the medical and surgical team, the later being ready to intervene if the slightest complication of a surgical nature develops.

About an experience of 7,757 investigations and after study of the published series in the literature, it appears the frequency of the accidents following vascular roentgenology has not really changed since ten years. -- 0,5% complications; 0,07% death in aortographies; -- 0,4% complications; 0,09% death in femoral artery catheterization; -- 3% complications; no death in axillary artery catheterization. The authors use the term "complications" when a surgical operation is necessary or after effects are present in the evolution. The study of the recent literature proves no significant amelioration in comparison with the last ten years. The accidents are analysed in aortography, in arterial catheterization using femoral or axillary arteries: the latter is the most dangerous. The considerable increment of the number of investigations suppressed the progresses provided by the material improvements. An explanation: in hospitals, it is necessary to train the students for roentgenology.

The authors present a clinical case of post-traumatic stenosis of the small intestine. The improvement in the quality of radiological diagnosis by the use of double contrast study of the small bowel after duodenal intubation is emphasised. On the basis of this case, together with a review of the literature, they review the various problems of diagnosis, physiopathology and histology which may be posed by these stenoses, which it would seem possible to integrate into a wider physiopathological group: ischaemic stenoses of the digestive tract.

The authors report a case of haemorrhage from the duct of Wirsung related to a pseudocyst of the pancreas ulcerating into a branch of the splenic artery. The diagnosis was made as an emergency by arteriography. 45 cases exist in the literature. Arteriography was performed in 10 cases. An arterio-canalar communication was demonstrated in only 3 cases.

The originality of this case report of malformed tumoral hemangioma of the mediastinum apart from its rarity (105 cases reported in the literature), concerns the patient's age (76 years old), when these tumors are predominantly observed in children and babies. The huge tumor size (800 gr), authorized the designation of giant tumor. The posterior mediastinal localization, when the usual site is in the anterior mediastinum. As in the majority of cases reported in the literature, total excision was possible. The tumor always has a benign character in the case of pure hemangioma, therefore the results are generally satisfactory.

The authors report a case of pheochromocytoma of Zuckerkandl's organ revealed by permanent hypertension. Angiography, combined with the clinical and biological data suggesting a catecholamine secreting tumor, made the diagnosis of pheochromocytoma of Zuckerkandl's organ prior therapy.

A congenital arteriovenous fistula of the kidney was discovered in a 75-year-old man presenting with hematuria and a silent kidney on I.V.U. The diagnosis had been suggested from the results of pre-operative arteriography examination. Treatment consisted of a total nephrectomy, because of the age of the patient and the hilar site of the "angioma". Reports in the published literature confirm the rare nature of this type of lesion and the difficulties encountered when trying to classify them in precise nosological groups.

The authors describe a case of post-traumatic arterio-portal fistula (APF), discovered on the 12th day after coeliomesenteric arteriography performed because of a postoperative complication, and emphasize the rare nature of this lesion, as shown by a review of the published literature. They stress the value of coeliomesenteric arteriography after urgent laparatomy for hepatic trauma for investigation of any possible lesions.

On the basis of 170 double-contrast radiographic examinations of the small intestine, a description is given, in the first part of this paper, of the technique employed. Emphasis is laid, on the one hand, on duodenal intubation, which is easily effected with a Dotter-Bilbao tube and, on the other, on a study obtained by filling with a continuous barium column, the double-contrast being merely an adjunct. In the second part of the paper the results are analysed from a photographic and diagnostic standpoint: Photographically, duodenal intubation affords a clearer visualization of the jejunum but the chief merit of double-contrast radiography lies in the visualization of the ileum and the study it makes possible of the last ileal fold. With regard to diagnosis, from personal series, 20 % of organic lesions have been observed, although it must be admitted that this figure is certainly boosted by the selectivity of a specialized gastroenterologic unit. The interest of this technique rests also on the fact that the examination is very well tolerated by the patient and does not last more than two hours on an average.