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Biomedical subjects

B Enon

Publications and source records attributed to B Enon.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Endodermal pulmonary tumor resembling a fetal lung].

We report a case of a 56-year-old man who developed a flu-like syndrome associated with weight loss. Chest X-ray revealed a homogeneous round lesion of the lung with sharply defined margins in the central lobe. At pathology, the tumor was found to be an endodermal pulmonary tumor resembling a fetal lung. This uncommon tumor is generally a fortuitous chest X-ray finding seen as a rounded peripheral opacity. Diagnosis is based on pathology examination of the surgical specimen. Complementary investigations are not contributory. Unlike blastoma, a differential diagnosis, prognosis is generally good.

Diagnosis, Differential↗
PubMed1999

[Essential thrombocythemia and cerebral ischemic accident: discussion of two cases].

Not only the total number of platelets but their normal or abnormal function are essential points to be analyzed in case of stroke associated with thrombocytemia. When possible the treatment of arterial episodes in thrombocytemia should not be surgical. Anti-platelet agents and the rigorous control of the different risk factors are warranted to limit the activation of abnormal platelets on early endothelial lesions and thereby limit the risk of recurrent accidents. We report two typical cases illustrating these different points.

Adult↗
PubMed1999

[Severe and distal ischemia of the upper limb. Results of a surgical follow-up of 11 years in 34 patients].

The aim of this retrospective study was to evaluate etiology, frequency and prognosis of the distal and severe arterial diseases of the upper limb treated in a vascular surgical unit. Between Jan. 1986 and Jan.1997, 34 patients, 22 males and 12 females, mean age 56 years (range 30 to 87 years) were followed in the vascular and thoracic surgical unit in Angers. Follow-up was 100% complete. Each patient was explored by selective angiography of the upper limb due to the critical characteristic of ischemia.19 patients (56%) had tissue loss. Among multiple etiologies, arteriosclerosis was found in 32% of the cases. When medical treatment was unsuccessful, a thoracic sympathectomy was attempted in 50% of the cases, and 21% of the patients had direct arterial surgery. Nine deaths, due to initial pathology, occurred during follow-up. Eight digitalis amputations were carried out whose two directly because serious necrosis. Severe arterial diseases of the upper limb represented 6, 4% of critical limb ischemia treated during this same period. At time, this study showed arteriosclerosis preponderance over systemic diseases, and the seriousness of cases referred to a vascular surgical center after unsuccessful medical treatment (J Mal Vasc 1999; 24: 368-372).

Adult↗
PubMed1998

[Angiosarcoma of the thoracic wall revealed by hemothorax].

Angiosarcoma is an uncommon tumor accounting for approximately 1% of all soft tissue tumors which, themselves account for 0.7% of all malignant tumors. Thoracic parietal localizations are reported exceptionally and prognosis is poor. We report the case of a 79-year-old woman who developed an angiosarcoma of the thoracic wall. The inaugural symptom was a hemothorax. Besides the localization, this case was particularly exceptional since the patient has remained asymptomatic three years after treatment by wide resection followed by radiotherapy.

Aged↗
PubMed1997

Chronic pain of vascular origin caused by a parietopulmonary fistula of the thoracic wall.

We describe the case history of a patient who suffered from dorsal thoracic nonpenetrating trauma after a fall, with rupture of the aortic isthmus treated by thoracotomy. Arteriovenous fistula between the thoracic wall and the lung, with hypervascularization of the left thoracic wall, was revealed by atypical chronic thoracic pain and a murmur. This case demonstrates that chronic thoracic pain of vascular origin must be considered.

Adult↗
PubMed1997

[In situ thrombolysis in the treatment of venous thrombosis of effort in the arm].

From March 1989 to March 1993, six athletic patients were treated in our institution by thrombolytic therapy for acute effort axillary-subclavian vein thrombosis in thoracic outlet syndrome. Mean age of these patients was 20 (range 14 to 27). An in situ infusion with urokinase (2,500 U/kg/h) and Heparin (100 U/kg/12 hours) was given during 64 hours (Range 14 to 72). Phlebography showed a complete reperfusion in three cases (the treatment began within an average period of 5.6 days), partial reperfusion in two cases (the treatment began within an average period of 8.5 days). In one case there was no reperfusion on phlebography: treatment began within an average period of 15 days. For this patient, a venous axillo-jugular bypass graft was performed. In all cases, there was no bleeding complication. A trans-axillary first rib resection was done three months later. Mean follow up was 31 months (range: two to 51 months). All patients recovered their previous physical status. Echo-Doppler exam showed normal subclavian vein flow in four cases, partial occlusion in one case and a total occlusion of the subclavian vein flow in one case. In this last case, the thrombolytic therapy failed to restore the permeability of the subclavian vein. Bypassgraft was patent. Axillary-subclavian vein thrombosis seen within a period of seven days should be treated by local thrombolytic therapy using urokinase and heparin.

Acute Disease↗
PubMed1996

Successful management of an aortoesophageal fistula using a cryopreserved arterial allograft.

We report a case of aortoesophageal fistula occurring as a complication of colonic esophagoplasty. Emergency treatment during the hemorrhagic phase combined aortic replacement using a cryopreserved arterial allograft and digestive tract exclusion. Immediate recovery and follow-up at 8 months were good. This is the first reported case of successful in situ aortic replacement using a cryopreserved allograft for an aortoesophageal fistula. The lack of previous reports of successful treatment and related treatment modalities are discussed.

Adult↗
PubMed1996

Aorto-colonic fistula as a late complication of colon interposition for oesophageal atresia.

A 22-year-old man developed severe haematemesis 21 years after colon interposition for long-gap oesophageal atresia. A fistula, from an anastomotic ulcer to the descending thoracic aorta, was discovered and treated successfully by surgical resection. This previously unreported complication highlights the need for the prevention of peptic complications following oesophageal replacement in children.

Adult↗
PubMed1996

[Surgical vein reconstruction in patients with tumor invasiveness of the superior caval system. Retrospective study of 7 cases].

We studied retrospectively all patients who underwent vascular reconstruction after tumor invasion of the superior vena cava in order to assess the surgical procedure. Seven patients were operated including 5 with compression of the superior vena cava. Compression regressed within 24 hours without recurrence. Reconstruction had no effect on morbidity and mortality. One patient is still alive after a 5 year follow-up. Invasion of the superior vena cava is not a contraindication for resection of a tumor localized in the thorax and may contribute to cure as it improved patient comfort in all cases.

Adenocarcinoma↗
PubMed1995

Eversion endarterectomy of the internal carotid artery: midterm results of a new technique.

A new eversion endarterectomy technique was used in 65 internal carotid artery reconstructions in 56 patients. The original features of the technique include a complete oblique transection of the internal carotid artery distal to the lesion and eversion endarterectomy through a longitudinal incision of the common carotid and external carotid arteries. The mean age of the patients was 68.2 +/- 7.8 years. Seventy-three percent of the patients had hypertension and 45.5% had coronary heart disease. Fifty-four percent experienced neurologic symptoms (transient in 36%, reversible in 6%, and permanent in 11%). Operations were performed under general anesthesia. An indwelling shunt was inserted whenever routine stump pressure was < 50 mmHg. There were no neurologic complications but one patient died of a compression hematoma of the neck, for a combined mortality and morbidity rate of 1.5%. Arteriograms were obtained from all patients on day 5 and showed complete restoration of normal anatomy in all cases and thrombosis of the external carotid artery in one. During a mean follow-up of 27 +/- 4.7 months no strokes were observed. Follow-up duplex scans showed no hemodynamically significant restenoses. Eversion endarterectomy is a reliable alternative to other reconstruction procedures of the internal carotid artery.

Aged↗
PubMed1995

[Arterial vascularization of the foot. Its importance in operations of revascularization of the lower limb].

Vascularization of the foot was studied using 50 intraoperative arteriograms on single legs and 50 cadaver injections. Arterial vascularization was shown to depend on supramalleolar anastomoses, the primary plantar arch and secondary arches. Anastomotic routes are essential for the permeability of femorotibial bypasses and cicatrization of distal trophic lesions when only one tibial artery remains permeable and must be revascularized.

Aged↗
PubMed1994

[Reverse endarterectomy of the internal carotid].

We have described an original technique of eversion carotid endarterectomy which has been performed in two series of patients. In the first series the patients were operated on in Angers. They were 65 carotid stenosis in 56 patients with a mean follow-up of 27 months (18-36 months). In the later series, the patients were operated on in Lyon. They were 51 carotid stenosis in 43 patients with a follow-up from 1 to 24 months. The two series were comparable in term of symptoms and grade of stenosis as determined by duplex-scan and arteriography. The technique which has been previously described is safe and presents a lot of advantages over classical endarterectomy or vein graft. We observed no postoperative neurological deficit and no postoperative thrombosis. Two residual stenosis (1.7%) were measured at 30% but they did show any impairment during two years of follow up in the first series. Eversion endarterectomy of internal artery is a safe and deficient alternative to others techniques in the surgical treatment of atherosclerosis stenosis of internal carotid artery.

Aged↗
PubMed1993

In situ thrombolysis for late occlusion of suprafemoral prosthetic grafts.

Low-dose urokinase was used to obtain in situ thrombolysis in the treatment of 20 late occlusions of suprafemoral prosthetic grafts in 19 patients. Aortofemoral or aortobifemoral bypasses with occlusion of one limb had been performed in nine patients, direct iliofemoral bypasses in six, crossover iliofemoral bypasses in two, and axillofemoral bypasses in three. Sixteen of the grafts were polytetrafluoroethylene and four were Dacron. Vascular surgery had been performed on an average of 3 years earlier. Thrombolysis was inhibited on an average of 3 days after onset of occlusion. The protocol called for penetration of the thrombus with a 5 F catheter inserted through a brachial (12 cases) or femoral (eight cases) route. After initial injection of 2500 units of urokinase a continuous infusion of urokinase was begun at a dose of 2500 units/hr and heparin at 100 units/kg/12 hr. Clinical, biochemical (fibrinogen and activated cephalin time every 6 hours), and arteriographic surveillance was carried out every 12 hours with progressive mobilization of the catheter until complete clearance of the artery. Clearance was achieved in all cases. Anteroposterior and occasionally lateral arteriograms with the hip joint in flexion were obtained. An organic cause amenable to treatment was found in 16 cases, including distal or proximal lesions (two and 10 cases, respectively) and elongation/kinking (four cases). Endoluminal angioplasty, stenting, or endarterectomy (six cases) and conventional procedures (10 cases) were also performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta, Abdominal↗
PubMed1993

[Macroscopic vascularization of the adult sternum. Implications of removal of the internal thoracic arteries].

The most of the arterial vascularisation of the adult sternum is on the dependence of the internal thoracic arteries. The best results of the aorto-coronary by-pass starting from this arteries are however subjected to more infectious complications. The study of this arterial supply, in "surgical" conditions, after sternotomy and ablation of one or two internal thoracic arteries show this devascularization. The residual arterial supply is only constituted by thin branches coming from intercostal arteries.

Adult↗
PubMed1992

Transthoracic endoscopy for upper thoracic chemical sympathectomy.

Beginning in April 1989, we have performed eight upper thoracic chemical sympathectomies by transthoracic endoscopy. The indications were occlusive arterial disease in four patients and Raynaud's syndrome and palmar hyperhidrosis in two patients each. Transthoracic endoscopy was performed under general anesthesia, through the third costal interspace on the anterior mid-clavicular line. Five ml of phenol were injected into the parietal pleura covering the three proximal thoracic ganglia. The duration of thoracic drainage was 24 hours. The postoperative course was uneventful except for one case of subcutaneous emphysema and transient Horner's syndrome in three instances. There were no initial failures. Because of its simplicity and the short hospitalization period, chemical sympathectomy by transthoracic endoscopy constitutes a valuable alternative to conventional surgery. This technique is, however, limited in the case of antecedent pleuropulmonary disorders.

Adult↗
PubMed1992

[Paraplegia after surgery of the suprarenal aorta (26 cases reported during a national survey)].

Although their frequency is probably underestimated, medullary complications of abdominal aorta surgery are rare but serious, and may be the cause of medico-legal actions. Referral of a patient allowed the collection of 26 unpublished cases: 18 with aneurysms, including 6 ruptured lesions and 12 undergoing cold surgery, and 8 with aorto-iliac occlusion, these 26 cases representing 0.16% of abdominal aorta interventions performed during the same period. Mortality (6 cases) was due principally to neurological complications, total in 4 cases, partial in 3 and persistent in 13. Risk factors were perioperative collapse (explaining the elevated frequency in ruptured aneurysms) and the occlusion of the internal iliac arteries. Duration of clamping was not significant. No certain method of prevention could be elucidated, either by a literature review or by analysis of the personal series.

Aged↗