PubMed Health⌕ Search

Biomedical subjects

F Cornud

Publications and source records attributed to F Cornud.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Interventional radiology in cancer of the exocrine pancreas and biliary tract].

Interventional radiology and operative endoscopy have considerably modified the diagnosis and treatment of neoplastic biliary obstruction. Ultrasound - or CT - guided needle biopsy provide a histological diagnosis without laparotomy. In almost every case, palliative treatment of jaundice can be performed by percutaneous stent insertion, due the combination of radiology and endoscopy. The major drawback of biliary drainage is the always possible distal obstruction of biliary stents.

Biliary Tract Neoplasms↗
PubMed1989

Indications for cholangioscopy.

Cholangioscopy permits new diagnostic and therapeutic procedures. It can be performed via the peroral route when anatomical conditions are suitable. This procedure was attempted in 6 cases (lithiasis in 5, malignant stenosis in 1): cholangioscopy proved possible in 4 cases, and lithotripsy was successful in 2 cases out of 3. Percutaneous transhepatic cholangioscopy was performed when peroral cholangioscopy was not possible (non-accessible papilla, hepatico-jejunostomy), or failed. In 17 patients with common bile duct (CBD) stones, unextractable by conventional procedures 14 underwent a cholangioscopy with electrohydraulic lithotripsy. Sixteen had complete clearance of the CBD. Cholangioscopy was attempted in 18 patients with intra-hepatic lithiasis. Lithotripsy was necessary in 10 cases and stenosis dilatation in 8. Results were excellent in 15 patients, and good in 3 with diffuse intra-hepatic lithiasis. In the case of lithiasis, the complication rate of the procedure was 29.5% and 27.7% for CBD and intrahepatic stones, respectively, and the mortality rate was 8.5% (n = 3). These complications (bleeding and cholangitis) are closely related to the percutaneous route. In malignant stenosis (n = 5), cholangioscopy was performed for diagnostic purposes in one case, extraction of a stent in one case and endobiliary laser treatment in 3 cases.

Adult↗
PubMed1989

[Treatment of urethral stenosis using Olbert's balloon dilatation angioplasty. Re-evaluation of the results].

Twenty-eight patients with an urethral stricture underwent Olbert's angioplasty balloon dilatation under local anaesthesia and fluoroscopic control. Four dilatations failed. Six were performed palliatively after failure of classical urethral catheterisation. Sixteen dilatations were performed curatively: thirteen patients developed a recurrent stricture after periods of between 3 days and 12 months. Three patients were cured. Our results suggest that angioplasty balloon dilatation is ineffective as a curative procedure and should be reserved for inoperable patients requiring and indwelling catheter, in whom classical catheterisation has failed.

Angioplasty, Balloon↗
PubMed1989

[Percutaneous treatment of abscess of the kidney and retroperitoneum].

Twenty eight abscesses or infected liquid collections located in the kidney or in the retroperitoneum were drained percutaneously. The abscesses were located in the renal parenchyma in most cases (14 cases), in the anterior pararenal space in 3 cases and in the iliopsoas muscle in 9 cases. In all cases, the drain was inserted under TV monitoring after needle puncture, which was most often guided by ultrasound. The percutaneous treatment was successful in 82% of all cases. Among the 5 unsuccessful attempts, 1 case of duodenal fistula required surgical treatment while the anterior pararenal abscess was effectively evacuated by the inserted drain, and 1 case of infected hydatid cyst was treated surgically immediately after the percutaneous needle puncture. Drainage is the first-line method for the treatment of abscesse of the kidney and retroperitoneum. It requires an appropriate technique and strict follow-up, which allow healing the lesion in most cases.

Abscess↗
PubMed1989

[Endoscopically "impassable" urethral stenosis. Catheterization under fluoroscopic guidance. Apropos of 11 cases].

In eleven patients with impassable urethral stenoses, we attempted retrograde catheterisation with an angiographic guide under fluoroscopic control. The stenosis was able to be negotiated with the guide in 10 cases (91% success). After dilatation by dilators (coaxial or rigid) or by Olbert's angioplasty balloon, we were able to introduce a Foley catheter into the bladder. The only failure was caused by a very marked separation of the two ends of the urethra due to trauma. This simple and effective method constitutes an alternative to immediate surgical treatment of endoscopically impassable urethral stenoses.

Fluoroscopy↗
PubMed1989

[Technical problems raised by renal puncture in the percutaneous extraction of coralliform calculi].

Initial puncture and dilation of nephrostomy track(s) remain difficult procedures in percutaneous extraction of staghorn calculi. Technical s adjuvants are necessary and are exposed in detail. The choice of the needle, of the wires and of the catheters for initial puncture and ureteral catheterization is explained. Techniques of "Y" tract and double puncture are exposed. Severe complications (3 cases) are reported. Extraction of up to 90% of the stone can be expected if these technical adjuvants are optimally used.

Humans↗
PubMed1988

[Dissolution of gallbladder lithiasis with methyl-tert-butyl-ether. Preliminary results: 9 cases].

Nine patients with gallstones were treated by injection of methyl-tert-butyl-ether (MTBE) into the gallbladder. Complete or incomplete dissolution was observed in 5 of the 9 patients. The 4 failures were due to 2 main factors: poor selection of the patients (2 of them had pigment gallstones) and inadequate mixture with the solvent floating above the bile and gallstones. In addition, 4 complications were noted, all of them being resolved by medical treatment. A better selection of the patients and a more efficient technique of MTBE injection should improve these results.

Adult↗
PubMed1988

[Acute cholecystitis after placement of biliary endoprosthesis. Treatment by percutaneous cholecystostomy].

Seven cases of acute cholecystitis (4 women and 3 men, mean age 73 years) were observed in a series of 192 patients treated by endoprosthesis for cancerous obstruction of the bile ducts between october, 1984 and october, 1986. The suspected clinical diagnosis was confirmed by ultrasonography. Cholecystostomy was performed by percutaneous puncture under ultrasonic guidance. A catheter was positioned in the gallbladder by the Seldinger technique in 3 cases and by the trocar technique in 4 cases. Pain in the right hypochondrium was relieved in all patients immediately after emptying of the gallbladder. Five patients were cured. One patient developed purulent peritonitis which was treated by surgery. A female patient died of her pancreatic cancer 3 days after cholecystostomy. Provided a number of precautions are taken to prevent leakage of the infected bile into the peritoneal cavity, percutaneous cholecystostomy is the treatment of choice for acute cholecystitis consecutive to biliary endoprosthesis.

Acute Disease↗
PubMed1988

Hepatitis tuberculosis presenting as tumoral disease on ultrasonography.

Macronodular involvement of the liver is a rare manifestation of hepatitis tuberculosis. Two cases of this pseudotumoral form are reported on ultrasonography, demonstrating multiple hypoechoic nodules distributed throughout the liver. The authors state the difficulty in differentiating this form in its atypical presentation from lymphomatous or secondary malignancies. They stress the importance of the bacteriological and/or histological diagnosis which can be performed with fine-needle percutaneous biopsy under ultrasound guidance and which allows effective therapy.

Adult↗
PubMed1988

[Transrenal percutaneous treatment of urinary fistula. Apropos of 19 cases].

Percutaneous nephrostomy (PCN) was used to treat 16 ureteral fistulas, two ileal fistulas following ileo-cystoplasty, and one pelvic fistula. Discharge resolved in all cases. PCN alone achieved complete recovery of the ileal and pelvic fistulas. Insertion of a wire-guide through the fistula into the bladder and stenting of the ureter for 5 to 20 days with a 8 to 10 F multi-side-hole catheter was possible in 12 of the ureteral fistulas and ensured complete recovery in every case. Because of complete stenosis, this procedure failed in the four other cases of ureteral fistula, and surgery was therefore required. Transrenal percutaneous treatment of urinary fistulas is a simple, effective procedure requiring only local anesthesia, and can be recommended in recently operated patients, and when retrograde catheterization is inadvisable (ileo-cystoplasty).

Humans↗
PubMed1987

Intracorporeal electrohydraulic shock wave lithotripsy of common bile duct stones: preliminary results in 7 cases.

We performed contact endobiliary electrohydraulic shock wave lithotripsy in 7 high-risk patient with unextractable common bile duct stones after EPT. The lithotripsy electrode was brought into contact with the stone through a percutaneous transhepatic approach in 5 cases and an endoscopic route in 5 cases. Firing of the shock wave was performed under fluoroscopic control in 4 patients and under endoscopic guidance via a transhepatic percutaneous cholangioscopy in 2 and peroral cholangioscopy in one case. Stones were fragmented in all the cases but one. Fragments were evacuated into the duodenum by simple lavage through the transhepatic drain in 5 cases, and by duodenoscopy in one. In 2 patients, hemobilia, which was controlled by transfusions, was observed. This type of percutaneous contact lithotripsy requires multiple maneuvers, which increase the risk and the hospital stay. Extracorporeal shock wave lithotripsy is simpler, but also has disadvantages. Peroral lithotripsy under endoscopic control performed immediately after EPT would be the most practical solution, but this technique implies the use of new fiberscopes and other energy supplies that are easier to handle.

Aged↗
PubMed1987

[Idiopathic spontaneous adrenal hematoma in adults: echography and x-ray computed tomography. Apropos of 5 cases].

The five patients presented with sudden lumbar pain, transient collapse, and a right hypochondrium palpable mass. The location and the type of the mass could be determined by ultrasonography which showed a septated heterogenous mass displacing the retroperitoneal fat anteriorly. Computed tomography showed in two cases tiny parietal calcifications and a spontaneous hyperdensity in one case. All the patients underwent surgery and no tumoral tissue could be found.

Adrenal Gland Diseases↗
PubMed1987

[X-ray computed tomography in the course of mediastinitis after sternostomy for heart surgery].

Results are reported of a prospective study of 79 CT scan examinations in 50 patients who had undergone sternotomy for cardiovascular surgery. In 69 cases the examination was conducted during the course of a progressive postoperative mediastinitis treated surgically. Mediastinitis was confirmed in 13 cases, including 12 relapses. In 2 cases the CT scan image was normal (2 false negatives) whereas mediastinal drains had been inserted. The CT scan image of mediastinitis shows mainly hypodense fluid collections (0 to 16 UH) in anterior mediastinum or between sternotomy borders (8 of 13 cases). But this type of image, detected 11 times in the absence of recurrence (favorable course), can result from a residual serous collection after ablation of drains. In 8 cases, a CT scan-guided puncture (7 cases) or one under ultrasound control (1 case) eliminated recurrence. The CT scan imaging also allowed diagnosis of 5 cases of osteitis, confirmed surgically. These findings indicate the definite interest of CT scan imaging in postoperative follow-up review of median sternotomies. It appears to be particularly indispensable for surveillance of surgically treated mediastinitis, because of the serious consequences of relapses and the often clinically silent chronic bone lesion. However, the possibility of residual serous collections emphasizes the importance of the clinical context and should lead to guided puncture investigation in doubtful cases.

Cardiovascular Diseases↗