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Biomedical subjects

F Cornud

Publications and source records attributed to F Cornud.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Percutaneous treatment of fistulas and stenoses after anastomosis of the uretero-digestive tract].

14 ureteral stenoses and 5 fistulae following an uro-intestinal anastomosis (UIA) were managed by a transrenal percutaneous approach. The stenoses (12 uretero-ileal and 1 uretero-colic anastomoses) were dilated with an angioplasty balloon and stented for several weeks. After withdrawal of the stent, performed on 12 out of 14 patients, the dilatation was successful in 8/12 cases (66%), with a follow up of 3 to 36 months. All the fistulae were dried. In 2 cases, complete recovery was achieved after placement of a bilateral nephrostomy tube. In 2 other cases, the ureter was stented at the site of the fistula which dried without sequelae after withdrawal of the stent. In the last case (uretero-colic diversion) surgery was performed after the fistula dried for the cure of a complete stenosis associated with the fistulae. The use of percutaneous nephrostomy is highly recommended for the management of post-operative stenoses and fistulae before considering surgical correction.

Colon↗
PubMed1987

[Prognostic value of x-ray computed tomography in acute pancreatitis: contribution of the injection of intravenous contrast media].

Thirty seven patients suffering from acute pancreatitis were explored using contrast-enhanced computed tomography (CT). The authors found a good concordance between the extension of the lesions on the initial CT examination, prognostic criteria on admission and the course of the disease. In addition, a new prognostic CT sign was reported in the early phase of parenchymal contrast perfusion, i.e. the lack of contrast-enhancement in a limited portion of the pancreas. This sign was present in 8 patients, all with severe clinical symptoms. These 8 patients showed the highest morbidity rate in the series with abscess-type complications occurring in all, compared with 24 p. 100 among the 29 other patients who did not exhibit this CT sign. Moreover, these 8 patients showed the highest mortality rate (25 p. 100 compared with 3.5 p. 100 among the other patients). An histological analysis of partial pancreatectomy specimens was performed in 7 out of the 8 patients. Devitalized pancreatic tissue, at the site of the parenchymal abnormalities on CT scan, was found in all cases. One false negative case was reported. Contrast-enhanced CT scan seems to be the most reliable method for diagnosing pancreatic necrosis during acute severe pancreatitis. It appears to be an useful prognostic predictor of morbidity. It can improve the outcome of the disease by depicting and guiding needle aspiration of a fluid collection, and/or surgery in case of clinical findings suggesting abscess formation.

Acute Disease↗
PubMed1986

[Benign ureteral stenoses. Dilatation with an angioplasty balloon].

An angioplasty balloon was used to dilate 23 benign ureteral stenoses in 21 patients. The anterograde approach through percutaneous puncture of the kidney was used in 19 cases. Following dilatation, an 8 F to 24 F catheter was left in the ureter. Dilatation was successful in 13 out of 23 cases (56%) followed up for 1 month to 2 years. It failed in 8 cases, and 2 patients are undergoing ureteral remodelling. Thus, dilatation of benign ureteral stenoses after percutaneous renal puncture was effective in about 60% of the cases. The follow-up period is still too short for us to determine the indications of this technique according to the cause and duration of the stenosis.

Adolescent↗
PubMed1986

[Urinary tract obstruction by Candida bezoars, or fungus balls].

Two patients admitted to an intensive care unit for severe bacterial infection develops Candida albicans superinfection with obstruction of the urinary canals by "fungus balls". The development of medico-surgical techniques using antibiotics and immunosuppressive drugs accounts for the increasing incidence of disseminated candidiasis. The kidneys are particularly sensitive to Candida infections. Fungus balls are conglomerates of mycelium which may result in obstruction of the urinary tract. Their clinical, radiological and ultrasonic features, as well as the microbiological and serological diagnostic problems they raise are described. Ultrasonically guided percutaneous nephrostomy is a very interesting technique for the diagnosis of the condition and its local treatment by drainage and lavage with amphotericin B. This antifungal, combined with flucytosine is still used for the systemic treatment of candidiasis.

Aged↗
PubMed1986

[Value of ultrasonography in the diagnosis of carcinoma of Vater's ampulla. Apropos of 9 cases].

In ten patients where ampullary carcinoma was proved, ultrasonography has been performed in 9 cases and failed in 1 case. The results reported, could be put into two different groups. In 7 cases out of 9, sonogram did not show any specific signs: In 3 of these cases, it mimicked a pancreatic carcinoma; in the other 4 cases, dilatation of biliary and/or pancreatic ducts has only been evaluated. In the 2 remaining cases (20% of the 10 patients of the series) the diagnosis of ampullary carcinoma could be suggested on sonographic features. It showed the "double duct sign" and a bulging mass filling the lumen of the distal common bile duct. In one of these 2 cases, the mass was also detectable in the second duodenum, previously filled with water. Endoscopy with biopsy is the most reliable procedure in the diagnosis of ampullary carcinoma but the interest of ultrasonography is: 1 degree to show suggestive findings when the tumor bulges in the common bile duct and the duodenum; 2 degrees to evaluate the tumor extension in the pancreatic parenchyma.

Aged↗
PubMed1986

[Real-time echography in the evaluation of the venous extension of cancer of the kidney. Prospective study of 50 cases].

Fifty patients with renal carcinoma were evaluated with real time ultrasonography: 15 tumors involved the renal vein (group Ia), 12 of them presented with caval tumor extension (group Ib); 35 tumors did not involve the renal veins (group II). In 3 cases, the renal vein could not be visualized. If the renal veins could be adequately delineated, evaluation of venous extension could be achieved in 100% cases (groups Ia and II). Nevertheless, caval tumor extension could be detected in only 70% cases (group Ib). This prospective study suggests that in the case of renal vein free of thrombus on ultrasonography, further investigations are not necessary to evaluate the venous extension of renal carcinoma. In case of inadequate delineation, or tumor involvement of the renal vein on ultrasonography, evaluation of inferior vena cava is mandatory, either by computed tomography, or inferior cavography.

Humans↗
PubMed1986

[Pyelo-duodenal fistula complicating pyelonephritis].

The authors report a case of a pyeloduodenal fistula secondary to a gravidic pyelonephritis. The diagnosis was based on intravenous urography. The etiology was probably an unnoticed dysectasia of the pyelo-ureteral junction. The patient recovered following nephrectomy and duodenal suture. The authors conclude with a discussion of the diagnostic and prognostic interest of percutaneous nephrostomy in the management of this rare complaint.

Adult↗
PubMed1986

[Treatment of jaundice caused by neoplastic obstruction of the bile ducts with percutaneous placement of endoprostheses: 53 cases].

From October 1983 to October 1985, 53 patients with malignant biliary obstruction were referred to our institution for a transhepatic biliary stent. One or two endoprostheses were inserted in 46 patients (87 p. 100). Stent insertion was usually performed in two sessions, after two or three days of external drainage. There were 23 men and 23 women. Their mean age was 70.6 years +/- 12 years (m +/- DS). Fourty-two patients (91 p. 100) were referred after failure of an endoscopic or surgical drainage procedure; fourty-four p. 100 of the patients had stage II or III high periportal obstruction. Five cases of severe early complications (11 p. 100) and 8 delayed complications requiring in-hospital treatment (17 p. 100) were observed. Among the latter, 7 were due to plugging of the endoprosthesis. All patients were unfit for surgery either because at a high operative risk or because of the extent of the cancer. Our results showed that percutaneous biliary drainage can be achieved in a high percentage of cases following failure of a surgical or endoscopic drainage procedure. The endoscopic transpapillary approach, which allows the insertion of 12 French endoprostheses in one session should be tried first. Percutaneous biliary drainage should be performed as a complementary procedure when endoscopic drainage has failed or in stage II or III high periportal obstruction associated with persistent jaundice or cholangitis.

Adult↗
PubMed1985

[Sensitivity of fine-needle puncture-biopsy in the histologic diagnosis of hepatic and pancreatic malignant tumors].

Aspiration-biopsies under ultrasound guidance, using a fine needle (external diameter inferior to 1 mm) have been performed in 61 malignant hepatic tumors (group I) and 25 pancreatic carcinomas (group II). Malignancy was diagnosed in 83 p. 100 cases; in group I, the sensitivity is 87 p. 100; the difference between hepatocellular carcinoma and liver metastases could be made in 88 p. 100 cases and in case of metastases, the site of the primitive carcinoma could be suggested in 77 p. 100 cases. In group II, the sensitivity is 72 p. 100. No complications were noted.

Biopsy, Needle↗
PubMed1985

[Can histological diagnosis of hepatic metastases be made by fine needle? Apropos of 70 hepatic punctures guided by echography].

The fine needle diagnosis of a malignant hepatic tumour is usually based on the cytology of the specimen. There have been very few reports concerning the possibilities of histological examination using the same needle. The authors report the histological results of 70 cases of aspiration biopsy of malignant hepatic tumours. They stress the importance of ultrasound guidance. The aspiration biopsy diagnosed the malignancy in 86 p. cent of cases. The difference between a primary tumour and a secondary tumour was established in 85 p. cent of cases and, in the group of 34 cases of hepatic metastases, the primary tumour was identified in 75 p. cent of cases. No complications were observed. The use of real time ultrasonography allows the visualisation of the needle throughout its course, so that large intra-hepatic vessels can be avoided and enabling the aspiration of deep intra-hepatic metastases and the aspiration of the periphery of necrotic tumours.

Biopsy, Needle↗
PubMed1985

[Percutaneous drainage of intra-abdominal abscesses guided by real-time ultrasonography].

From October 1982 to October 1984, a percutaneous drainage under realtime ultrasound guidance was performed in 53 patients with abdominal abscesses. The location of the abscesses was subphrenic (23), retroperitoneal (16), and intrahepatic (14). A safe access route was found by using ultrasound and fluoroscopy in 53 out of 55 patients (96 p. 100). Percutaneous drainage failed in 8 patients and 3 of these patients died. The causes of death were: cerebral abscess (1), renal failure after surgery for correction of a duodenal fistula (1), and pancreatic abscess (1). The other five patients were cured by surgical drainage. Two complications were observed: one case each of pneumothorax and purulent peritonitis. Forty-five patients were healed by percutaneous drainage without operation. The duration of the catheter drainage was 14 days +/- 13 (m +/- 1 SD). Our results suggest that percutaneous drainage under realtime ultrasound guidance is an efficient and safe way to treat abdominal abscesses.

Abdomen↗
PubMed1985

[Percutaneous nephrostomy and its applications. Personal experience].

211 percutaneous nephrostomies (PCN) have been performed on 189 patients under combined fluoroscopic and reel time ultra-sound guidance. 4 major complications occurred with consisted in one hemorrhage and 3 septicemias. Indication of the PCN was diagnostic in 35 cases and therapeutic in 176 cases. Decompression of pyelo-caliceal system (89 cases) among with 72 in emergency, drying of an urinary fistula (8 cases), balloon dilatation of benign ureteral stenoses (18 cases) and treatment of 60 renal stones (3 dissolutions and 57 extractions). Results showed the drying of the fistula in all cases, the long term success of the balloon dilatation in 50% cases and 80% success rate of stone extraction.

Adult↗
PubMed1984

[Echography of tumors with multiple localizations in the urinary tract. Apropos of 2 cases].

The authors report 2 cases of unilateral non functioning hydronephrotic kidney, associated with homolateral bladder tumoral filling defect. Cystoscopy and histology showed a non infiltrating tumor. In one case, sonography showed a diffuse tumoral proliferation from the renal pelvis to the bladder and in the other case revealed a tumor located in the lower ureter prolapsed into the bladder. Both were non infiltrating ureteral tumors on histologic examination. These sonographic features, suggesting that the level of obstruction was not the bladder, accounted for the contradiction between urographic findings and lack of histological infiltration.

Adult↗