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Biomedical subjects

H Thouard

Publications and source records attributed to H Thouard.

13 recordsLinked to original sources
PubMed2000

[Inflammatory abdominal aortic aneurysm].

A 58-years-old man, with no medical past history, was examined for abdominal pain and weight loss. An enlarged kidney could be palpated, and abdominal echography showed left hydronephrosis due to ureteral compression by abdominal aortic aneurysm. Laboratory data showed an inflammatory syndrome. CT scan suggested the diagnosis of inflammatory abdominal aortic aneurysm. The use of corticosteroids brought about the regression of the symptoms and the resolution of the ureteral obstruction, permitting aneurysmectomy and prosthesis replacement without ureterolysis. This report shows the interest of preoperative radiological diagnosis of the inflammatory character of abdominal aneurysm. For uncomplicated cases, preoperative treatment using corticosteroids could allow partial regression of the periaortic inflammation and easier surgical repair.

Abdominal Pain↗
PubMed1999

[Post-traumatic vena cava thrombosis].

BACKGROUND: Post-traumatic thrombotic events are exceptional in the caval system. We report a case of inferior vena cava thrombosis in a traffic accident victim. CASE REPORT: A 53-year-old male victim of a traffic accident suffered multiple trauma including blunt trauma of the abdomen. Three months after the accident, the patient was hospitalized with signs of pulmonary embolism proven by angiopneumography. Phlebocavography evidenced a thrombus floating in the inferior vena cava. DISCUSSION: We found 9 other cases of caval thrombus secondary to abdominal trauma in the literature. Tht thrombus usually developed due to endothelial damage secondary to shear forces. Computed tomography of the abdomen with contrast injection contributes greatly to diagnosis. Treatment is a matter of debate due to the prognosis dominated by the risk of massive embolism.

Abdominal Injuries↗
PubMed1999

[Youthful popliteal aneurysm].

Popliteal artery aneurysms are not so clinically frequent but are the most common site of peripheral aneurysms. They usually affect men aged over sixty and are caused by atherosclerosis. Whenever they concern younger men, other more unusual aetiologies such trauma, infection, inflammatory arteritis or popliteal entrapment are responsible. The authors report the first written observation of small size popliteal aneurysm, revealed by intermittent claudication in a 33 years old subject, of which the origin is accelerated atherosclerosis. The evolution after resection of the popliteal aneurysm and end-to-end anastomosis with saphenous vein was favorable. This observation reminds us of various popliteal aneurysm aetiologies, not excluding atherosclerosis due to young age and also underlines that the small size of these aneurysms does not protect against embolism risk.

Adult↗
PubMed1998

[Appendicular pseudo-tumors: unusual diagnosis].

The discovery of a tumour mass of the appendix, in an acute or chronic context, raises the problem of its benign or malignant, inflammatory or infectious nature. We report five cases of patients operated by the same surgical team between June 1991 and September 1996, who presented macroscopically and histologically with unusual appendicular pseudotumours: appendicular diverticulosis (n = 1), Crohn's disease localized to the appendix (n = 2), yersiniosis (n = 1), actinomycosis (n = 1). The preoperative diagnosis was acute appendicitis (n = 2) or tumour (n = 3). The postoperative course was uneventful in every case, and specific medical treatment was prescribed in two cases (yersiniosis and actinomycosis). These differential diagnoses must be considered in all appendicular diseases, but they are extremely difficult to confirm preoperatively.

Actinomycosis↗
PubMed1997

[Perineal-genital wounds in war medicine. Apropos of 18 cases].

Perineo-genital wounds involving the anterior perineum or the urogenital perineum are uncommon; 1-4% of all war wounds. We report 18 cases observed in war situations. Isolated uretrogenital wounds are rarely life-threatening, but the functional prognosis is always compromised in these men whose mean age is under 30 years. Debridements should be limited and all isolated lesions should be repaired early with tight suture of the cavernous body albuginea, preservation of viable testicular and adnexal tissue (but the rate of orchidectomy is greater than 50%), and immediate suture of any wound to the urethra rather than simple alignment. In war situations, these wounds are usually caused by perforating or blast trauma. The wounds are complex, with damage to the soft tissues, sometimes involving lesions to the anal sphincter, the gluteal masses or the abdomino-pelvic structures. Laparostomy for hemostasis is justified. The risk of sepsis is high, requiring triple antibiotics, cystostomy, careful debridement, discharge drainage or possibly colostomy. Treatment of urogenital lesions is a secondary operation in these cases but must not be neglected if the mictional and sexual functions are to be preserved.

Adult↗
PubMed1997

[Secreting retroperitoneal paraganglioma. Apropos of a case].

A case of secreting, asymptomatic retroperitoneal paraganglioma is presented. Paragangliomas are rare neuroendocrine tumors and the malignant behaviour, higher than pheochromocytomas, is based on metastases or local recurrence. The treatment is complete surgical excision. Radiotherapy and chemotherapy may be used for palliation of symptoms.

Chemotherapy, Adjuvant↗
PubMed1996

[Portal vein thrombosis and rupture of the esophagus secondary to a barotrauma].

Portal vein thrombosis complicating a trauma is rare. We report a case of portal vein thrombosis associated with esophageal rupture after a blast injury due to the explosion of a pressurized nitrogen bottle. Portal vein thrombosis was discovered during oesophageal reconstruction, 70 days after the initial injury. A favorable outcome was observed.

Adult↗
PubMed1996

[Strangulated obturator hernia. Contribution of abdominal x-ray computed tomography].

We report two cases of obturator hernia diagnosed on CT scans. This examination contributes to both diagnosis and evaluation of prognosis allowing for improved treatment by reducing the number of intestinal resections. Abdominal CT is becoming the first line examination for all occlusion or subocclusion syndromes with no obvious diagnosis.

Aged↗
PubMed1996

[Cystic duplication of the esophagus, a rare etiology of dysphagia. Apropos of a case].

A case of an upper oesophageal duplication in a 44 year old man was reported. Dysphagia was the only clinical signs and further examinations CT Scan, MRI performed for diagnosis. Surgical treatment (thoracotomy) was performed and postoperative complication was underlined. Cysts with oesophageal structure are unusual anomaly and surgery is difficult and dangerous.

Adult↗
PubMed1993

[Synovial sarcoma of the abdominal wall. Apropos of a case].

On the basis of one case of malignant synovioma exceptionally located in the abdominal wall and of a review of the literature, the authors give the highlights on the current clinicopathological, evolutive and prognostic data shared by all malignant synoviomas, whatever their location. Finally, they discuss the specific diagnostic and therapeutic issues of the abdominal site.

Abdominal Muscles↗
PubMed1982

Aneurysmal bone cyst of the cervical spine: report of a case investigated by computed tomographic scanning and treated by a two-stage surgical procedure.

The authors report the case of a 62-year-old woman with an aneurysmal bone cyst of the cervical spine. The patient presented with a progressive tetraparesis. Cervical computed tomographic scanning revealed a mass involving three contiguous vertebral bodies. The patient underwent two consecutive surgical procedures: (a) laminectomy and metallic plate osteosynthesis and (b) an anterior approach for curettage of the cyst and autologous grafting. Twelve months after operation, the patient was given a course of radiation therapy in the cervical area. She was found to be asymptomatic at the 20-month follow-up examination. The authors discuss the etiological, anatomical, and radiological features of vertebral aneurysmal bone cysts and evaluate treatment methods.

Bone Cysts↗