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F Dunham

Publications and source records attributed to F Dunham.

25 records · Page 2Linked to original sources
PubMedDate not supplied

[Treatment of adenocarcinoma of Vater's ampulla].

We reviewed the records of 51 patients. In two-thirds of the cases the main symptom was icterus; one third presented with pain. The whole group underwent a retrograde choledocho-pancreatography. An abnormal papilla was found in 80% of the cases. This finding proved to be of sufficient diagnostic importance without the necessity of an associated choledocho-pancreatography for diagnostic confirmation. Although in the majority of the cases the choledochus proved to be dilated, pancreatic duct enlargment was only noted in 50%. The only treatment in the very elderly patient was endoscopic sphincterotomy. Younger patients underwent a duodeno-pancreatectomy preceded by an endoscopic sphincterotomy. The morbidity and mortality associated with endoscopic opacification of the biliary and pancreatic ducts and sphincterotomy in this setting is much higher than for all other indications in general. For this reason we propose to perform a choledocho-pancreatography only when indispensable for diagnostic purposes (nl. papilla) or when endoscopic sphincterotomy is the chosen treatment modality.

Adenocarcinoma↗
PubMedDate not supplied

[Complementarity and limits of the different technics of pancreatic morphologic investigation for the diagnosis of acute pancreatitis and complications (author's transl)].

The authors have previously proposed the endoscopic retrograde cholangio-pancreatography as a technic to be used systematically in acute pancreatitis; it offers a precise diagnosis of microlithiasis and a possibility of an immediate endoscopic treatment. They have studied the pancreatographic patterns in 355 cases of clinical acute pancreatitis; the pancreatogramm allows the diagnosis of chronic pancreatitis in acute phase in 1/3 of the patients; necrosis is present in 12% of the 240 patients without any radiological signs of chronic pancreatic disease. The computerized axial tomography gives a precise definition of the extra-pancreatic extension of the necrosis; the ultra-sound technic is better for the late complications of acute pancreatitis. The authors consider that these 3 examination technics must be performed at the admission or/and be part of the workup before surgery.

Acute Disease↗
PubMedDate not supplied

[Interest of bilio-pancreatic morphologic study in management of acute pancreatitis (author's transl)].

The interest of morphologic investigations in the diagnosis, the prognosis and the treatment of acute pancreatitis was analyzed in a series of 120 patients. The systematic endoscopy of the biliary tract yields a distinction between the biliary and the non-biliary sources of pancreatitis and can be followed immediately by an endoscopic sphincterotomy. Th morphological study of the bilio-pancreatic area can complete the prognostic indexes defined by the clinical and biological data, document the extension of the intra- and extrapancreatic necrosis and precise the indication and the choice of a surgical treatment.

Acute Disease↗