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C Bastid

Publications and source records attributed to C Bastid.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Percutaneous alcoholization of the celiac plexus under echographic guidance: an alternative to splanchnicectomy? Study of 21 cases].

Celiac plexus block is usually performed under fluoroscopic or tomodensitometric guidance. We report on a new procedure using sonographic guidance. The patient lies in supine position. We use a real-time sonograph (Kontron Sigma 1 AC) with a 3.5 MHz probe. On a transverse plane, the celiac axis is localized emerging from aorta. After local anesthesia, the tip of the spinal needle (177 mm, 22 G) is placed close to aorta (about 5 mm) on both sides. 10 to 15 ml of 1 per cent lidocaine then 10 to 15 ml of absolute alcohol are injected on each side. 21 patients (10 males, 11 females, mean age: 61) underwent the procedure. They presented with cancer of the pancreas in 14 cases, metastatic nodes in 3 cases, cholangiocarcinoma in 2 cases and chronic calcifying pancreatitis (CCP) in 2 cases. No pain relief occurred in 3 patients (14 per cent). On of those presented with CCP but the endoscopic cystic diversion of a small cyst was successful to eradicate pain. Partial pain relief occurred in 5 cases (24 per cent). Total pain relief was obtained in 13 cases (62 per cent). No complication related to the treatment was observed. Sonography is a simple and safe method of guidance to perform alcohol block of the celiac plexus. The anterior approach may prevent neurologic complications related to other methods of guidance.

Celiac Plexus↗
PubMed1990

[Value of cyto-puncture and of ultrasonic-guided micro-biopsy in solid tumors of the pancreas].

43 patients (29 men, 14 women, average age 64.7 years) with a solid lesion of the pancreas underwent echography-guided cytopuncture (needle 22 G, 88 mm) associated in 11 cases with microbiopsy (needle 21 G, 150 mm). The lesions were localized in the pancreatic head (n = 27), body (n = 13) and tail (n = 3). The sensitivity and specificity of cytopuncture were 81% and 100% respectively. There were 27 true positives (26 pancreatic adenocarcinomas and one metastasis of a prostatic adenocarcinoma); 10 true negatives (5 cases of calcifying chronic pancreatitis, 3 benign endocrine tumors, 2 cases of acute pancreatitis); and 6 false negatives (4 adenocarcinomas and 2 intrapancreatic cholangiocarcinomas). There were no false positives. Microbiopsy diagnosed 5 adenocarcinomas out of 9 cases biopsied and 2 benign endocrine tumors not detected by cytopuncture. Its sensitivity was thus 56% for malignant lesions and 64% for all lesions biopsied. Its specificity was 100%. There was one (= 2.5%) complication (dissemination on the needle pathway). We conclude that echography-guided cytopuncture is a simple and effective method of diagnosing solid tumors of the pancreas. Biopsy, though of lower sensitivity, probably serves to increase the specificity of cytopuncture, in the case of benign lesions in particular.

Adenocarcinoma↗
PubMed1990

Eosinophilic pancreatitis: report of a case.

A case of relapsing pancreatitis in a young man is presented. Stenosis of the main duct and cystic lesions of the tail of the pancreas were shown by ultrasonography, CT scan, and endoscopic retrograde cholangiopancreatography (ERCP). After a wrong diagnosis of cancer, the pathological examination demonstrated an eosinophilic infiltration of the pancreatic tail, spleen, lymph nodes, and spleen flexure of the colon. After treatment with oral cromoglycate, the previously increased rate of polynuclear eosinophils in blood returned to normal. Similar observations were found in the medical literature.

Adult↗
PubMed1990

Spontaneous healing of sclerosing cholangitis associated with stricture of the main pancreatic duct.

A 78-year-old man was admitted for jaundice. Strictures of the main pancreatic duct and of the main bile duct in the head of the pancreas were showed by ERCP. This association initially evoked a cancer of the head of the pancreas. A prosthesis was endoscopically inserted in the main bile duct. Three months later, strictures of intrahepatic bile ducts appeared, demonstrated by ERCP. The diagnosis of sclerosing cholangitis or of liver metastases was suggested. Twenty-eight months later, cholangiography and pancreatography were normal, ruling out a malignant lesion. Presently, the patient is in good condition with no biological abnormality. This observation is interesting because it shows that some cases of sclerosing cholangitis may heal spontaneously. It shows the necessity of having histological proof of pancreatic cancer.

Aged↗
PubMed1990

Diameter of the main pancreatic duct in chronic calcifying pancreatitis. Measurement by ultrasonography versus pancreatography.

The aim of this study was to compare the diameter of the main pancreatic duct measured by ultrasonography (US) and endoscopic pancreatography (ERCP) in cases of chronic pancreatitis and to evaluate the ability of US to gauge the dilation of the main duct accurately enough to do a side-to-side wirsungo-jejunostomy. Sixty-one measurements were recorded in 50 patients (47 men and 3 women; age: 43.7 +/- 10 years). In 11 cases, two measurements were made at an interval of more than one year. US always preceded ERCP. The measurements were compared in only 43 cases (71%), because evaluation by US was inaccurate in 14 cases (23%) and by ERCP in nine cases (15%). The mean value of the diameter measured by US was 4.30 +/- 3.01 mm, and by ERCP, 5.52 +/- 3.08 mm (mean +/- SD). When the diameter assessed by US (y) was greater than or equal to 3 mm, the diameter assessed by ERCP (x) was always greater than or equal to 4 mm. The value of x could be determined from y by the equation: x = y + 1.2 mm (r = 0.91, p less than 0.05) The difference between x and y was constant and did not depend on the size of the duct. It could be owing to the hyperechogenicity of the duct walls. We conclude that US is a reliable way to assess the dilation of the main pancreatic duct and might be an acceptable method of judging whether a side-to-side wirsungo-jejunostomy can be performed.

Adult↗
PubMed1990

Villous adenoma of the main pancreatic duct: a potentially malignant tumor?

This report deals with two cases of villous adenoma of the Wirsung duct. The two patients presented with upper abdominal pain, diarrhea, and weight loss. Duodenal intubation showed a complete failure of exocrine pancreatic function. Ultrasound scan, computed tomography, and endoscopic retrograde cholangiopancreatography disclosed marked dilatation of the head portion of the main pancreatic duct. A proximal duodenopancreatectomy was performed. Pathological examination revealed a papillary polyp expanding the pancreatic head and filling the main duct lumen. Histological pattern consisted of a villous adenoma without any feature of malignant change. Previously reported cases exhibit many similarities to our two cases. The putative likelihood of malignant change and the relationship between villous tumors of the Wirsung duct and of other origin remain unclear.

Adenoma↗
PubMed1990

Does jaundice increase the frequency of gastroduodenal ulcerations?

We have studied the frequency of gastric and duodenal ulcerations in 200 jaundiced patients (106 males, 94 females, mean age: 69.1) compared with 100 patients without jaundice (65 males, 35 females, mean age: 47.8). The study was designed to determine the effect of sex, age, duration and etiology of jaundice on the frequency of ulcerations. Each patient underwent ERCP, with careful examination of the stomach and duodenum. Ulcerations were seen in 35 patients with jaundice (17.5%) and in 2 patients without jaundice (2%). The difference was significant for duodenal ulcerations (p less than 0.01), but not for gastric ulcerations. There was no significant difference in the influence on the frequency of ulcerations of sex and duration of the jaundice. Ulcerations were more frequent in the case of neoplastic obstruction of the main bile duct (p less than 0.001) than in other etiologies.

Aged↗
PubMed1988

[Endoscopic treatment of pseudocysts and abscess in acute pancreatitis].

We report on 4 cases of necrotic pseudocysts complicating acute pancreatitis, treated by endoscopic cystostomy (3 cystogastrostomies, 1 cystoduodenostomy). Acute pancreatitis was secondary to biliary stones in 2 cases, post-surgical in one case and post-ERCP in the last case. Endoscopic treatment was performed because of recurrence of pseudocysts after percutaneous drainage guided by ultrasonography or CT scan. In 3 cases, pseudocysts were infected (pancreatic abscesses) and in 2 patients, surgery was contraindicated (severe respiratory and multiple organ failure). The outcome was uneventful in all the 4 cases and pseudocysts disappeared in a few days or weeks in 3 patients. The fourth patient underwent a complementary surgical cystogastrostomy. Endoscopic cystostomy appears to be a safe and efficient technique when performed in pseudocysts located close to the digestive wall and responsible for bulging visible during upper GI endoscopy.

Abscess↗
PubMed1987

Biliary ascariasis combined with a villous tumor of the papilla. Diagnostic and therapeutic value of endoscopy.

A 64-year-old man admitted for cholangitis presented with an ascaris lumbricoides in the biliary duct and a villous tumor of the ampulla of Vater. ERCP revealed the parasite as a "rail-like" linear defect in the main bile duct, and permitted its extraction. The ampullary tumor was repeatedly ablated with a snare and finally surgically removed because of suspicion of malignancy. This is the first report on such an association.

Ampulla of Vater↗
PubMed1987

Endoscopic cystoduodenostomy of cysts of chronic calcifying pancreatitis: a report of 20 cases.

This paper reports on the technique and results of 20 endoscopic diversions into the duodenum of cysts complicating chronic pancreatitis in 19 patients. The procedure, performed safely on the condition of visualization of a compression of the duodenal wall by the cyst, was successful 18 times in 17 patients. Complications occurred in four patients: two with bleeding (resulting in the death of one patient), two perforations treated successfully, and one transient cholangitis. Long-term results (average = 20.7 months) in 13 patients who were followed more than 6 months were good nine times, fair three times, and bad in one case. Endoscopic cysto-digestive diversion appears as an interesting alternative to surgery in selected patients with chronic pancreatitis.

Adult↗