Biomedical subjects
Publications and source records attributed to C Chaulieu.
Twenty two patients presenting a typical sonographic pattern of tumefactive biliary sludge are studied. In all cases was observed a polypoid mobile, rounded mass, without acoustic shadow. The lesion stayed in the gallbladder in 15 cases and in distended main bile duct in 3 others. There was a double localisation in 4 cases. Seven verified cases proved to be constituted of very thick biliary sludge.
The authors describe the radiologic appearance of annulo-aortic ectasia in 26 patients who had plain chest radiography and aorto-seriography. Two also underwent C.T. Aortography is the most performing method to appreciate the extent of aortic ectasia, the perturbations of the aortic root and to diagnose acute or chronic dissections. Aortography remains a most valuable complement of echocardiography for preoperative staging.
By means of a review of a series of 30 cases of hepatic alveolar echinococcosis, the authors propose a classification of the various sonographic patterns; they point out the heterogeneous form which associate necrosis and calcification inside an hyperechoic mass and is the most frequent. The interest of ultrasonography for detection of lesions, its limits for diagnosis of extension, the contribution of percutaneous biopsy are discussed, as its place in the survey of the affection.
Radiologic findings are described in 4 cases of annular pancreas in adults. The value of double contrast exploration of the duodenum is emphasized, this showing the characteristic image of "curtain-loop" stenosis of the right D2 border with associated marked dilatation of the suprastenotic duodenal zone. Ultrasound imaging shows features suggestive of the liquid distended genu superius. The onset of acute pancreatitis on an annular pancreas leads to images of pseudo-cystic necrosis and/or calcifications suggestive of the diagnosis because of their localization on ultrasound or C.T. examination.
The authors recall the main pathologic and physiopathologic data necessary to understand the angiographic patterns of hepatic alveolar echinococcosis, by means of a rereading of a personal series of 37 cases. They show that this affection has a diagnostic angiographic shape which associate four signs: avascular aspect of the lesions, regular invasion of vessels, presence of a collateral circulation, absence of neovascularisation. Digestive angiography stays a good diagnostic method for the parasitosis, when epidemiological context, ultrasound or CT scan gave no explicit conclusion. It keeps an interest in the preoperative evaluation and in the supervision of portal vein.
Lipomas rarely occur in the liver. However, because of the widespread use of ultrasound and CT in the diagnosis of liver disease, one should be familiar with their appearance, as confirmed diagnosis may spare the patient major investigations. The value of CT is emphasized in association with percutaneous biopsy when the appearance of the tumour is not classical. Ultrasound patterns are discussed.
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Ultrasonographic images were correlated with radiological and pathological findings in a case of generalized adenomyomatosis of the gallbladder. Emphasis is placed on the importance of the methods employed for filling the biliary tracts with opaque medium, to confirm a suspected diagnosis suggested by the heterogeneous irregular thickening, with a fringed internal limit, of the gallbladder wall.
The acquired or congenital nature of Riedel's lobe, a rare anomaly of hepatic lobulation, is a subject open to controversy. Normally asymptomatic, it presents as a palpable mass in the right hypochondrium leading to possible confusion with an hepatic or a renal tumor. Correct diagnosis can be established by the characteristic findings an ultrasonography. The typical anatomical and clinical features of this hepatic morphological variant are discussed in relation to ultrasound recordings obtained from three patients with a Riedel's lobe.
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Ultrasonographic examination in a patient with gallbladder calcification demonstrated a spiral image analogous with that observed in sclero-atrophic gallbladder lithiasis. A straight film of the abdomen should be performed before ultrasonographic exploration, as before any examination of the biliary tract employing an opaque medium.
Renal sarcomas are rare malignant connective tissue tumors and they only represent 1 to 5% of renal cancers, according to various authors [18]. The appearance of a primary osteogenic tumor within a renal sarcoma is an extremely rare occurrence, and the mechanism by which it develops is not completely understood. The two interesting points raised by the case described in this report were the possibility of suspecting the diagnosis of renal osteogenic sarcoma on a straight x-ray film, and the images observed on ultrasonography.
The peculiarity of lung hematomas is due to the association of two types of lesions: vascular ruptures and alveolar ruptures. Six original observations are associated to 68 others published by various authors in a detailed general review. The main characteristics are radiological, with the following stages: 1) diffuse confusion giving a widespread picture of a low density and imprecise outline, 2) constituted hematoma with a dense picture with clear cut outline of late diagnosis, 3) less frequently aero-hydric pictures. Evolution takes place by slow spontaneous resorption which does not always require surgery.
Angiographic investigations in 9 patients with partial or total post-traumatic secondary impotence present for several years, confirmed the presence of traumatic vascular lesions involving, in nearly all cases, the artery of the penis or its branches (cavernous and bulbar arteries). Selective angiography of the pudendal arteries was able to guide treatment in 5 of these patients. Epigastrocavernous anastomoses, according to the microsurgical procedure developed by Michal, were performed with excellent results in 3 cases.
The differential diagnosis of cancer and abscesses of the kidneys with perinephritic inflammatory masses is sometimes difficult. In these cases, radiological examination of the colon can be of great value by demonstrating the presence of inflammatory colonic perivisceritis. Double contrast examination can reveal the presence, not only of an inflammatory type of narrowing, but characteristic changes in the mucous folds of the transverse "in palisade" type with thickening extending throughout the circumference of the colon. These appearances are totally different from those observed in malignant colonic perivisceritis. The use of double contrast examination of the colon, in cases of renal masses and associated fever, can enable the choice to be made of an adequate route of approach (lumbotomy), of it demonstrates the characteristic appearances of inflammatory perivisceritis.