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D Alison

Publications and source records attributed to D Alison.

At least 19 recordsLinked to original sources
PubMed2006

[Mesenteric hematoma: Unusual complication of a long term oral anticoagulation therapy].

Authors report a case of a 77 years old man who developed a small bowel mesenteric hematoma as consequence of an unusual complication from a long term oral anticoagulation treatment. Computed tomoangiography helpfully suggests diagnosis of a mesenteric hematoma and refuts an organic cause as vascular anomalies, by an equivalent method to conventional angiography, noninvasely. In our case report, patient's deterioration justified an emergency surgery corroborating medical imager findings. Authors review the rare cases previously reported.

Administration, Oral↗
PubMed2006

[Suspected non-accidental trauma in children: pseudofracture of the parietal bone].

We reported the case of a three month old child who was suspected of abuse syndrome because of a possible parietal bone fracture during radiographic investigation. At autopsy, the parietal bone abnormalities were not fractures, but proved to be unossified membranous strips. A review of the literature about normal variants of parietal suture on roentgenograms was made to avoid the diagnosis of non-accidental trauma in children, especially in live children where autopsy cannot be made.

Child Abuse↗
PubMed2006

[The role of aortic morphology in the occurrence of hypertension in patients undergoing surgery for coarctation of the aorta before the age of 1 year].

OBJECTIVE: Hypertension on effort can be observed following surgical treatment of coarctation of the aorta even if the operation has been performed early and has been judged to be satisfactory. The pathophysiology of this hypertension has not been completely elucidated. The aim of our study was to look for a residual morphological anomaly of the aortic arch which might be responsible. METHODS: This was a retrospective study of patients aged over 10 years who had undergone surgery for coarctation of the aorta before the age of 1 year, consecutively between 1979 and 1993, and free from re-coarctation clinically or with Doppler. All of them had a blood pressure effort test on a cycling machine, echocardiography and an MRI of the thoracic aorta. RESULTS: 61 patients were included. Their median age was 15 years, 59% were male, 15% were hypertensive at rest and 56% on effort. With univariate analysis, only the average blood pressure (p=0.03) and the resting pulse pressure (p=0.001) were associated with hypertension on effort. With multivariate analysis the only factors that correlated independently with maximum arterial pressure on effort were the height of the patient (p=0.02) and the pulse pressure (p<0.0001). The surgical technique and the age at intervention were not associated with hypertension on effort (p=0.96 and 0.69 respectively). The diameter of the horizontal aorta and the aorta at the site of repair, measured on MRI, added to the diameter of the descending aorta at the diaphragm were not lower in patients with hypertension on effort (p=0.77 and 0.38). There were proportionally more Roman type aortic arches than Gothic types in patients with hypertension on effort, but this difference was not significant (p=0.18). CONCLUSION: In our study, the patients with hypertension on effort following correction of coarctation of the aorta did not display any residual obstruction at the level of the aortic cross on MRI. However, they had a resting pulse pressure that was significantly higher than the non hypertensive patients, reflecting an increase in the aortic wall rigidity.

Adolescent↗
PubMed2005

Is ultrasound lymph node examination superior to clinical examination in melanoma follow-up? A monocentre cohort study of 373 patients.

BACKGROUND: There is still lack of consensus regarding the most effective follow-up for stage I and II melanoma patients although some consensus conferences have provided guidelines stating that clinical examination should be the standard. OBJECTIVES: Our aim was to study the value of adding ultrasound lymph node examination (7.5 MHz) to the routine clinical examination recommended by French guidelines in melanoma follow-up. METHODS: A cohort of melanoma patients was enrolled between 1 July 1995 and 1 July 2000 in a follow-up protocol including clinical examination performed four times a year for thick melanomas (Breslow index > or = 1.5 mm) and twice a year for thin melanomas (Breslow index < 1.5 mm) according to French guidelines, and ultrasound lymph node examination performed every 6 months for thick melanomas and every year for thin melanomas. Follow-up was continued up to 1 July 2003. When clinical or ultrasound examination indicated signs of node recurrence, surgical biopsy of the involved node was performed. When ultrasound examination was only suspicious, another ultrasound examination was performed within the following 3 months. The results of both clinical and ultrasound examinations were compared with histopathology examination when node biopsy was performed. RESULTS: Ultrasound follow-up was performed for 373 patients (213 females and 160 males). Mean age at diagnosis of melanoma was 59 years (range 14-90, SD 15). In total, 1909 ultrasound examinations combined with clinical examination were analysed. Node biopsy was performed in 65 patients and demonstrated melanoma metastases in 54. Sensitivity of clinical examination and ultrasound examination was 71.4%[95% confidence interval (CI) 55.4-84.3] and 92.9 (95% CI 80.5-98.5), respectively, P = 0.02. Specificity of clinical examination and ultrasound examination was 99.6% (95% CI 99.2-99.8) and 97.8% (95% CI 97.0-98.4), respectively. Despite this apparent superiority of ultrasound examination over palpation, only 7.2% of the patients really benefited from ultrasound examination (earlier lymph node metastasis detection or avoidance of unnecessary surgery), while 5.9% had some deleterious effect from ultrasound examination (unnecessary stress caused by repetition of ultrasound examination for benign lymph nodes, useless removal of benign lymph node). CONCLUSIONS: This study confirms the greater sensitivity of ultrasound examination to clinical examination in the diagnosis of node metastases from cutaneous melanoma. However, the place of ultrasound in routine follow-up is at least questionable as only a very small proportion of patients (1.3%) really benefited from adding ultrasound examination to clinical examination.

Adolescent↗
PubMed2005

[Evaluation after 20 years of a case of Takayasu's disease that presented with aortic regurgitation].

Takayasu's disease is a segmental multifocal affection of medium and large arteries. The diagnosis is based on the association of stenotic and aneurismal lesions of the aorta and its branches secondary to an inflammatory infiltration of the media and adventitia. Cases of aortic regurgitation associated with aneurismal dilatation of the ascending aorta as the presenting features of Takayasu's disease, as in this case, are rare. Histological examination of the aortic wall may help establish the diagnosis by showing signs of aortitis. The other usual arterial lesions are sometimes missing at the initial phase of the disease. A late histological diagnosis may be difficult as the inflammatory lesions tend to be progressively replaced by fibrotic lesions or a banal atheroma.

Aortic Valve↗
PubMed2004

[MR imaging in the evaluation of blunt pancreatic trauma].

Pancreatic injuries caused by blunt trauma are unusual but associated with a high morbidity and a high mortality because of a delay in diagnosis. Clinical and laboratory findings are non-specific. Accurate grading of blunt pancreatic injury with identification of pancreatic duct disruption helps to define practical treatment guidelines. Computed tomography does not allow direct visualization of the pancreatic duct and may result in low accuracy for the detection of ductal injury. Endoscopic retrograde pancreatography is the "gold standard" but invasive (3-5% complication rate, mainly pancreatitis) and may not be possible in up to 30% of patients, or requested after surgery. Endoscopic retrograde pancreatography may be used as a therapeutic modality (stenting of the main pancreatic duct). Magnetic resonance cholangiopancreatography is non invasive and preliminary results are promising. Magnetic resonance cholangiopancreatography detects pseudocysts, has multiplanar capability and complemented with conventional MR imaging allows evaluation of the pancreatic parenchyma.

Humans↗
PubMed2004

[Gastric necrosis from acute dilatation without underlying psychiatric disorder].

Acute gastric dilatation with necrosis is a rare and severe complication associated with anorexia nervosa, bulimia, and psychogenic polyphagia. The Authors report an unusual case without underlying psychiatric context. Gastric necrosis was suspected based on imaging findings (plain radiograph and computed tomography). The detection of these imaging signs in an appropriate clinical setting, even without underlying psychiatric context, is important to avoid any delay in diagnosis and reduce mortality.

Abdominal Pain↗
PubMed2004

Partial thrombosis of an idiopathic azygos vein aneurysm.

Aneurysms of the azygos vein are often asymptomatic, detected on a chest radiograph simulating paratracheal mass. When the aneurysm is totally thrombosed, it is impossible to distinguish it from another cause of mediastinal mass. A case is presented in which partial thrombosis of the aneurysm and communication with the superior vena cava led to a diagnosis on angiography and CT.

Adult↗
PubMed2003

[Characterization of adrenal incidentaloma discovered with tomography. General review].

The detection of an incidentaloma at abdominal Computed Tomography (CT), except CT features that permit a specific diagnosis (hemorrhage, myelolipoma or cyst), become a problem to differentiate adenomas from "non adenomas" (primary or secondary malignancy) incidentalomas. A density of ten Hounsfield units or less with a nonenhanced CT is a feature of benign incidentaloma (essentially lipid-rich adrenal adenomas). There are two limitations of this characterization: incidentalomas initially detected at enhanced CT and lipid-poor adrenal adenomas. The relative enhancement washout on enhanced CT, by using a threshold of 50% washout, permit then to characterized as adenomas or "non adenomas" incidentalomas on a 10-minute-delayed enhanced CT. Limitations of this characterization are only for benign pheochromocytomas and atypical adrenal cortical carcinomas.

Adrenal Gland Neoplasms↗
PubMed2003

[Enterolith ileus: a rare complication of small bowel diverticulosis].

An elderly patient with subacute small bowel obstruction due to an enterolith that evolved within a small bowel diverticulum is reported. Presence of small bowel diverticulum is not rare. But small bowel obstruction secondary to an enterolith formed within a small bowel diverticulum is a rare complication. Enterolith ileus closely resembles gallstone ileus in its clinical presentation. Diagnosis can be established only by documenting the absence of aerobilia and the presence of small bowel abnormality causing stasis, like small bowel diverticulosis.

Aged↗
PubMed2003

[Isolated dissection of the superior mesenteric artery].

Isolated spontaneous dissection of the superior mesenteric artery is uncommon. We report a case complicated by arterial rupture and discuss diagnostic imaging work-up. Diagnosis is usually made by conventional arteriography. But, dissection can also be diagnosed noninvasively by computed tomography angiography and ultrasound.

Aortic Dissection↗
PubMed2003

[Iatrogenic renal perforation during percutaneous angioplasty].

Percutaneous transluminal angioplasty is recommended as the first choice of therapy for renal artery stenosis. However, morbidity and mortality are significant. Among hemorrhagic complications, renal perforation is unusual. A case is reported, caused by the use of an angled hydrophilic guidewire, in which the diagnosis has been made by computed tomography angiography with typically perirenal hematoma and extravasation of contrast material corresponding to the perforation. This complication has been successfully treated with conservative measures.

Angioplasty, Balloon↗
PubMed2003

[Congenital absence of a cervical spine pedicle: misdiagnosis in a context of trauma].

Absence of a cervical spine pedicle is an exceptional congenital anomaly with a characteristic radiographic triad: i) absence of pedicle producing a pseudo-enlargement of the homolateral foramen, ii) dysplastic aspect with posterior displacement of the homolateral facets and lamina, and iii) defect or absence of the homolateral transverse process. It is particularly important to recognize this radiographic picture in order to avoid misdiagnosis, e.g. unilateral fracture-displacement of the facet joints in a context of acute trauma, as occurred in our case, or pathological enlargement of the foramen (neurofibroma) without trauma. We describe the radiographic presentation of this congenital anomaly, stressing the importance of a homolateral oblique view and the usefulness of computed tomography for correct diagnosis.

Adult↗
PubMed2003

[Radiologic appearance of epiploic appendages and their complications].

A wide spectrum of pathologic processes can involve epiploic appendages, and primary epiploic appendagitis is the most frequent. Pathologic processes are today more frequently identified with the increased use of radiological assessment (ultrasound and computed tomography) of patients presenting with acute abdominal pain. Recognition of specific imaging abnormalities of complications enables the radiologist to make the diagnosis, thus allowing appropriate treatment.

Colon↗
PubMed2002

[Association of D-dimer and helicoidal thoracic scanner for diagnosis of pulmonary embolism. Prospective study of 106 ambulatory patients].

OBJECTIVE: Ventilation/perfusion pulmonary scintigraphy (PS), the current mainspring in the diagnosis of pulmonary oedema (PE), is frequently non-conclusive. The objective of this study was to determine, prospectively, the diagnostic value of the association of D-dimers and helicoidal thoracic scanner (HTS) in a continuous series of ambulatory adults with suspected PE and admitted to a cardiologic emergency unit. METHODS: Exclusion criteria were as follows: symptoms or clinical signs of seventy, contraindication for HTS and/or on pulmonary angiography, curative anticoagulant therapy for more than 48 hours, history of PE less than 3 months before or the impossibility of conducting all the examinations with 48 hours. All the patients underwent determination of D-dimers by rapid ELISA test, HTS and 2 reference examinations, venous Doppler of the lower limbs and a PS, completed by pulmonary angiography if the PS did not permit diagnosis and the venous Doppler was negative. RESULTS: One hundred and six patients were selected over a recruitment period of 18 months. The prevalence of PE was of 45% (48/106). Forty-four of the 48 PE of the series were central form. HTS was considered dubious in 10 patients (10.4%, PE+ n = 2, PE- n = 8). The results of D-dimers were negative in only 34.5% patients without PE (20/58). Pulmonary angiography was necessary in 15 patients. The negative and positive predictive values of D-dimers were respectively of 100 and 55.8% (48/86) and those of HTS respectively 100 (46/46) and 92% (46/50). CONCLUSION: The diagnostic strategy of clinical suspicion of PE, starting with determination of D-dimers by rapid ELISA test followed by helicoidal thoracic scanner in the case of a positive result, was particularly effective in this series of patients with a high prevalence of PE. These results must be confirmed in a larger series and in a general emergency unit.

Adult↗