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Biomedical subjects

A Porcel

Publications and source records attributed to A Porcel.

At least 19 recordsLinked to original sources

Characteristics of missed lung cancer on chest radiographs: a French experience.

The purpose of this study was to report 30 cases of missed lung cancers and describe characteristics of each case. Reasons for misdiagnosis were analyzed from the report. Each radiograph was subsequently reviewed by a panel of two experts who quantified several parameters regarding image analysis and film quality. Lesions were not described in 67% of the cases and were misinterpreted as benign processes in 33% of cases. Comparison to previous chest radiographs and clinical information were seldom available on the report. Size of the lesions varied between 1 and 7 cm, location was primarily apical and paramediastinal, normal anatomy was highly or moderately complex in 87%, and distracting lesions were present in 63% of the cases. Image quality was considered perfect in 3 cases only. Among all the factors responsible for missed lung cancer, certain factors can be improved as film quality, comparison with previous radiographs, and better awareness of clinical information.

Adult↗

[Small intestine adenocarcinoma with Crohn's disease].

We report a 57-year-old male with a 11-years history of Crohn's disease who developed small bowel adenocarcinoma. The patient was admitted with intestinal partial obstruction and he underwent a laparotomy because an abscess in right lower quadrant was suspected. He was successfully treated with resection and adjuvant chemotherapy, without evidence of recurrence after a 2-year follow-up. A review of the literature reveals that about 100 cases have been reported. We describe the distinguishing features of small bowel adenocarcinoma arising in Crohn's disease and we emphasize the difficulty in making an early diagnosis.

Adenocarcinoma↗

[Spontaneous bacterial peritonitis from Campylobacter fetus].

A patient with cirrhosis and ascites who developed spontaneous bacterial peritonitis due to Campylobacter fetus is described herein. This organism has been increasingly associated with bacteremia and localized infections in patients with cirrhosis and other immunocompromised states, but spontaneous bacterial peritonitis has been rarely reported. We review Campylobacter fetus infections and their relationship to development of spontaneous bacterial peritonitis, and we emphasize that prolonged antimicrobial therapy is required.

Campylobacter Infections↗

[Pelvic emergencies in women].

Emergency pelvic imaging is currently based on transabdominal and transvaginal sonography. Life threatening emergencies such as ectopic pregnancy and annexial torsion can be diagnosed by these technics. Doppler imaging (pulsed Doppler and color encoded) improve the diagnostic efficacy in an emergency context. Evaluation of pelvic inflammatory disease, cyst bleeding and placental disruption in best obtained by US because of its simplicity, safety and low cost.

Adnexal Diseases↗

[Interventional radiology and abdominal emergencies].

Interventional radiology used in acute abdominal diseases has demonstrated its efficacy in most emergency cases especially in patients at high risk for surgery. Percutaneous drainage is a reference standard for abscesses located within the abdomen and pelvis with high success rates of up to 80%. The diagnosis and treatment of gastrointestinal hemorrhage have changed over the past two decades, with decreased diagnostic examinations and advances in pharmacologic therapy and improved endoscopic techniques. On the other hand, embolization techniques and new procedures such as trans jugular intra hepatic porto systemic shunt have been developed. Arterial embolisation in many situations such as blunt or direct trauma, obstetric or post operative hemorrhage, can be used as an effective easy and relatively safe technique with high success rates to stop bleeding and save the organ. Percutaneous drainage and angiographic techniques adapted to biliary and urinary tree have also been developed as well as endoscopic procedures, allowing treatment of stenoses by balloon dilatation, or plastic or metal prostheses. Indications, technical aspects, complications and limits of these various procedures are presented.

Abdomen, Acute↗

[Digestive perforations and occlusions].

Acute abdominal disorders are common reasons for consultation at the emergency department. The diagnosis of all acute abdominal disorders begins with a careful history and physical examination. When appropriate, the clinical examination should be supplemented by conventional plain abdominal radiography. Gastrointestinal perforation and obstruction are very commonly encountered in the diagnosis of acute abdomen. Plain abdominal radiographs are the initial diagnostic methods of choice. In some circumstances, ultrasonography and CT may be valuable for the evaluation of the cause of abdominal disorder.

Abdomen, Acute↗

[Abdominal emergencies of infectious origin].

Infectious disease is a common cause of acute abdomen. The diagnosis is based on clinical examination and basic laboratory tests. However, medical imaging routinely performed according to the clinical findings is frequently useful. Hepatic and splenic abscesses are correctly demonstrated by ultrasonography and computed tomography. Ultrasonography is the reference standard for the diagnosis of acute cholecystitis. The US examination is also performed for the diagnosis of appendicitis and its complications. Ultrasonography and barium enerna are commonly performed for the evaluation of signoid diverticulitis. Computed tomography is the reference standard to determine medical or surgical procedures.

Abdomen, Acute↗

[Value of laparoscopy in ascites of undetermined origin].

OBJECTIVE: To assess the diagnostic accuracy of laparoscopy in the study of patients with ascites of unknown cause, and the frequency of laparoscopy use for that indication after the advent of ultrasonography and computed tomography. DESIGN: A retrospective study of 4.536 laparoscopies performed in 16 years, in two periods of 8 years, and the correlation with the pathologic diagnosis. PATIENTS: 137 patients in whom laparoscopy was indicated for the study of ascites of unknown cause. RESULTS: 63.5% of laparoscopies were performed over the first 8-year period, and 36.5% in the second (p = 0.0001), and for the study of ascites 2.6 and 3.8% respectively. Laparoscopy and biopsy were diagnostic in 98.5% of cases; 51% carcinomatosis, 17.5% liver cirrhosis, 11.7% hepatic neoplasm and others. Two of five cases of peritoneal tuberculosis were considered carcinomatosis at laparoscopy. There were no serious complications. CONCLUSIONS: The advent of new imaging method has reduced the use of laparoscopy, although it is still employed frequently for the study of ascites. Laparoscopy with biopsy when necessary has an excellent effectiveness and accuracy for the diagnosis of ascites of unknown cause.

Ascites↗

[Cancer of the esophagus: value of medical imaging].

Medical imaging defines the local, regional and metastatic spread of cancers of the oesophagus, guiding the therapeutic approach and, in particular, the indication for surgery. CT scan and echoendoscopy are currently the reference examinations. MRI provides complementary elements. After treatment, imaging is performed to detect operative complications and recurrence.

Endoscopy, Digestive System↗

[Esophagus: postoperative aspects].

Although endoscopy has replaced radiology for the diagnosis of diseases of the oesophagus, postoperative imaging still remains essential. The radiological investigation depends on the initial disease, and its technique is adapted to the suspected complication and the type of operation performed. Immediately postoperatively, a barium swallow allows verification of the surgery before reintroducing food. The early diagnosis of possible complications is based on the barium swallow and CT scan. At a longer interval after the operation, medical imaging, particularly barium swallow, allows anatomical and functional postoperative surveillance. Relapses of the initial disease, particularly neoplastic recurrences can be distinguished from an intercurrent disease or a mechanical complication due to the operation.

Esophageal Diseases↗