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Biomedical subjects

B Andreassian

Publications and source records attributed to B Andreassian.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Severe tracheobronchial complications of the ingestion of caustics in adults. A case of perforation healed with a pulmonary patch].

Since 1969, in a study of 100 patients hospitalized for severe caustic ingestion meeding intensive surgery, the authors have found 9 cases of critical tracheo-bronchic burns characterized by necrotic lesions. Those lesions constitute a severe complication (6 deaths amongst 9 patients) thus the obsolute necessity of precocius and repeated tracheobronchic fiber endoscopies. In case of an ulcerating or pre-splitting aspect appearing in localised necrotic lesions, the authors preconise in emergency a tracheobronchic plasty using a lung patch. Other treatments are discussed.

Adult↗
PubMed1984

[Recent tracheobronchial ruptures caused by closed injuries of the thorax. Diagnosis and complications in 18 cases].

Tracheo-bronchial ruptures are serious complications of thoracic trauma. The authors report their experience of 18 cases: 3 tracheal ruptures, 3 tears in the tracheal or bronchial membrane, 11 unilateral bronchial ruptures and 1 bilateral bronchial rupture. Diagnostic endoscopy was performed immediately in 9 cases, with a delay of 2 to 3 days in 6 cases and with a longer delay (15th, 23rd and 25th days) in 3 cases. The treatment was non-operative in the 3 cases with membranous tears. The other patients were operated by resection of the contused area and end-to-end anastomosis of the ruptured extremities: within 24 hours following the diagnosis in 10 cases, and after a delay in the 5 other cases. The post-operative course was uncomplicated in 13 cases; 1 patient developed a bronchial stenosis requiring pneumonectomy and 4 patients died, including 2 from infective lesions due to delay in the diagnosis.

Adolescent↗
PubMed1983

[Adventitial cyst of the aorta].

The authors report a case of adventitial cyst of the abdominal aorta. This would seem to be the first time that a cyst has been reported in the literature with this localization. A 54 year old female patient was treated surgically for a suspected aneurysm of the abdominal aorta. Her antecedents included syphilis treated with bismuth. The condition began with a lumbago with no clearly defined etiology. An abdominal X-ray without preparation visualized a calcified abdominal tumor in a retroperitoneal position, apparently attached to the aorta. Arteriography showed that the tumor was excluded from the circulation. Surgical exploration of the aorta demonstrated a cystic tumor, which was resected. A review of the literature concerning the pathology of arterial cysts shows no previous cases of aortic cyst. On the other hand, references to identical anomalies of the iliac, femoral, popliteal and radial arteries provide grounds for discussion of the etiology of this aortic disease. The macroscopic data and histological studies suggest a phenomenon of cystic degeneration rather than a constitutional anomaly of the artery, or, in this particular case, an anomaly connected with syphilitic lesions.

Aorta, Abdominal↗
PubMed1983

[Treatment of an aneurysm of the abdominal aorta above a transplanted kidney. Renal protection by inert subclavian-femoral bypass].

Opening and grafting of an aneurysm of the abdominal aorta located between and below the renal arteries were carried out in a 44-year old patient with a transplanted kidney in right hypogastric position. Renal ischaemia during clamping of the aorta was prevented by means of an inert bypass between the right subclavian and femoral arteries. The patient's renal function remained normal. The different techniques available to protect renal transplants are compared.

Adult↗
PubMed1983

[Surgical approach to the 3rd segment of the vertebral artery by a paramedian posterior route].

Following an anatomical study of the lateral suboccipital region, the authors have devised an approach to the third segment of the vertebral artery, from C2 to the foramen magnum, which enabled them to treat an arteriovenous fistula in C1 while preserving the vertebral artery. The different operative stages and anatomical features are described. The simplicity and safety of this approach should encourage surgeons to use it.

Arteriovenous Fistula↗
PubMed1983

[The abdomen in multiple-injured patients. Comparative study on 225 multiple-injured patients with and without abdominal lesions. Incidence of abdominal complications].

Of 225 patients with multiple injuries and a high lesional score, 100 presented traumatic abdominal lesions. Comparison of the two groups confirmed both the usefulness and validity of a traumatic index and the reliability of abdominal puncture-lavage. Abdominal complications were analyzed. Mortality in all multiple injury cases, with or without abdominal lesions, was identical in this series where emergency surgery was performed only for lesions affecting vital organs, the mean age of patients with abdominal lesion being significantly lower. An attitude to adopt when deciding whether surgery is necessary is proposed.

Abdominal Injuries↗
PubMed1982

[Value of mediastinoscopy and mediastinotomy in exploration of the mediastinum (author's transl)].

The value of the information provided by mediastinoscopy or cervical mediastinotomy was evaluated in 150 cases by means of tests measuring diagnostic efficiency with calculated agreement coefficient. An accurate histological diagnosis was made in 100 out of 116 mediastinal syndromes (adenopathy, mediastinal or paramediastinal tumors). In cases with negative results exploratory surgery is required. The operability of bronchial carcinoma was assessed in 34 cases selected for their location and radiological extension. A negative mediastinoscopy makes it very unlikely that an inoperable cancer will be found. In bronchial carcinoma, mediastinoscopy is recommended whenever the risk attending excision of a tumor with lymph node involvement is to be weighed against the high operative risk in a debilitated patient. The usefulness of these exploratory procedures is enhanced by anterior mediastinotomy in cases with anterior tumor and in some left-sided bronchial cancers.

Adolescent↗
PubMed1982

[Penetrating thoracic and abdominothoracic wounds. Results of treatment in 221 cases (author's transl)].

Overall mortality after treatment of 221 thoracic or abdominothoracic wounds was 5 p. cent in a recent series, mortality from bullet wounds being the double of that from other weapons. Isolated thoracic wounds without cardiac lesions have a good prognosis, whereas mortality after heart or abdominothoracic wounds remains high (12.5 p. and 14 p. cent respectively). Apart from those with severe hepatic injuries or wounds of the suprahepatic veins, most of the injured patients that died were in cardiac arrest on arrival. Different therapeutic attitudes are necessary for pure thoracic wounds and those involving the abdominothoracic region. It is essential to gain as much time as possible at all stages, particularly during transport of the injured and when deciding the course of treatment, to avoid losing patients with curable lesions.

Abdominal Injuries↗
PubMed1982

[Esophageal perforation during tracheal intubation. Report on 6 cases. (author's transl)].

Perforation of the esophagus and hypopharynx followed tracheal intubation for general anesthesia or during intensive care in 6 patients. Circumstances favorable to the production of these lesions, and diagnostic features enabling early diagnosis are discussed. Simple surgical procedures and intensive postoperative care resulted in recovery in 5 of the 6 cases.

Aged↗
PubMed1982

[Vertebral arteriovenous fistula. Surgical technic by the paramedian posterior approach].

Description of an arterio-venous fistula of the suboccipital V3 portion of the vertebral artery in a male of 48. The first clinical manifestation of the fistula was a bruit following an injury, which had produced i.a. a mandibular fracture. For various reasons, the authors are of opinion that the fistula was rather congenital than traumatic. The technique of a paramedian surgical approach of the lesion is described. The authors think that this is a valuable procedure in the treatment of vertebral arterio-venous fistulas in the region between C2 and the foramen magnum.

Arteriovenous Fistula↗
PubMed1980

Hemophilia A in a phenotypic female with normal male karyotype associated with a low factor XII level.

Hemophilia A was detected in a 40-year-old black Gabonese female prior to thoracic surgery for empyema. The diagnosis of mild hemophilia A was supported by the findings of low factor VIII coagulant activity (VIII:C 4%), normal levels of factors VIII related antigen (VIIIR:Ag) and VIII von Willebrand (VIIIR:WF), without detectable circulating anticoagulant. Neither the patient nor her immediate relatives had past histories of abnormal bleeding. The physical features were phenotypically female with developed breasts, pubic hair and normal external genitalia: however, she had primary amenorrhea, a blind vagina with no uterus and her karyotype was 46,XY. These findings are consistent with the diagnosis of testicular feminization thereby explaining the apparent contradiction between the phenotype and the known six-linked inheritance of hemophilia A. In addition to factor VIII deficiency a low level of factor XII (20%) was detected although it cannot be concluded whether the patient is truly factor XII deficient or whether she represents a low variant of the normal distribution.

Adult↗