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Biomedical subjects

J C Couffinhal

Publications and source records attributed to J C Couffinhal.

At least 19 recordsLinked to original sources
PubMed1991

[Pseudotumoral lipid pneumopathies. Apropos of six cases].

In cases of localised pneumonia due to oil aspiration, the diagnosis may be difficult and is often assessed by thoracotomy. Six cases of lung paraffinoma are reported. The lesion, localised in the lower lobe in five patients out of six, was discovered on screening chest x-rays. In two cases, two lesions were observed in the same patient. All six patients underwent lung resection. Diagnosis was made on histologic examination showing foreign body reactions against oil. Oil aspiration was due to oily nose drops in one patient and to the use of paraffin oil on a tracheostomy in two others. The preoperative diagnosis may be suspected on bronchial lavage CT scan and MRI. When the diagnosis is strongly suspected, thoracotomy can be avoided as in some cases withdrawal of the medication can be followed by progressive resolution of the radiological signs.

Aged↗
PubMed1988

[Acquired systemo-pulmonary fistula after pleurectomy responsible for a continuous thoracic murmur].

Systemo-pulmonary fistulae are rare. The case of a 27 year-old man, hospitalized for exploration of a continuous thoracic murmur, is reported. A right pleurectomy had been performed 2 years previously because of a recurrent spontaneous pneumothorax, and no murmur was present at that time. Angiography showed a systemo-pulmonary fistula with the right internal mammary artery and branches of the right axillary artery as afferent vessels, and the right pulmonary arteries and veins as efferent vessels. Blood gases measurements demonstrated a left-right shunt. The acquired nature of the fistula was suspected because of the history of right pleurectomy and the acquired nature of the murmur. There was no indication for surgery because of the complexity of the fistula and the absence of symptoms.

Adult↗
PubMed1984

[Evaluation of vascular surgery with digital subtraction angiography. A study of 127 patients].

We have performed digital subtraction angiography (DSA) on 127 patients treated by vascular surgery. This technique was easily and safely performed in outpatients, without any complication. Our experience indicates that DSA is accurate for post operative evaluation in 96% of cases. In digestive arterial surgery, some examinations (3.3%) are insufficient. Distal run off is usually well seen, everywhere, except in kidneys. There is a good correlation between angiographic results and clinical status. However, significant abnormalities were discovered in 5% of cases without any clinical signs. Digital intravenous angiography is a safe and mildly invasive procedure for postoperative evaluation of vascular surgery.

Angiography↗
PubMed1983

[Adventitial cyst of the aorta].

The authors report a case of adventitial cyst of the abdominal aorta. This would seem to be the first time that a cyst has been reported in the literature with this localization. A 54 year old female patient was treated surgically for a suspected aneurysm of the abdominal aorta. Her antecedents included syphilis treated with bismuth. The condition began with a lumbago with no clearly defined etiology. An abdominal X-ray without preparation visualized a calcified abdominal tumor in a retroperitoneal position, apparently attached to the aorta. Arteriography showed that the tumor was excluded from the circulation. Surgical exploration of the aorta demonstrated a cystic tumor, which was resected. A review of the literature concerning the pathology of arterial cysts shows no previous cases of aortic cyst. On the other hand, references to identical anomalies of the iliac, femoral, popliteal and radial arteries provide grounds for discussion of the etiology of this aortic disease. The macroscopic data and histological studies suggest a phenomenon of cystic degeneration rather than a constitutional anomaly of the artery, or, in this particular case, an anomaly connected with syphilitic lesions.

Aorta, Abdominal↗
PubMed1983

[Treatment of an aneurysm of the abdominal aorta above a transplanted kidney. Renal protection by inert subclavian-femoral bypass].

Opening and grafting of an aneurysm of the abdominal aorta located between and below the renal arteries were carried out in a 44-year old patient with a transplanted kidney in right hypogastric position. Renal ischaemia during clamping of the aorta was prevented by means of an inert bypass between the right subclavian and femoral arteries. The patient's renal function remained normal. The different techniques available to protect renal transplants are compared.

Adult↗
PubMed1983

[Radiological picture and surveillance of nontraumatic aortic dissections of the descending aorta].

A retrospective study of 32 cases of acute dissecting aneurysms of the aorta forms the basis for further discussions on the role of arteriography. This is the only examination enabling full visceral investigation in type B dissecting aneurysms (affecting the descending aorta only) treated medically. The possible need for revascularization surgery will depend upon the results of this investigation, the type of arterial lesions affecting the visceral branches being determined by assessment of visibility of arteries in relation to the true and false lumen.

Aortic Dissection↗
PubMed1982

[Ureterovesical reimplantation. A technic derived from Lich and Gregoir's procedure].

Fifty-five uretero-neocystostomies were carried out using a technique derived from the Lich-Gregoir technique. Tightness is ensured anastomosis and burying over the vesical dome, with minimal vesical opening; the anti-reflux system is effective. Urinary complication of this ureter transplantation method are now rare, in our series, only two complications due to necrosis of the ureteral segment were observed. This technique could be used in all obliterations of the ureter, whether accidental or by necessity, located near the bladder.

Humans↗
PubMed1982

[Value of mediastinoscopy and mediastinotomy in exploration of the mediastinum (author's transl)].

The value of the information provided by mediastinoscopy or cervical mediastinotomy was evaluated in 150 cases by means of tests measuring diagnostic efficiency with calculated agreement coefficient. An accurate histological diagnosis was made in 100 out of 116 mediastinal syndromes (adenopathy, mediastinal or paramediastinal tumors). In cases with negative results exploratory surgery is required. The operability of bronchial carcinoma was assessed in 34 cases selected for their location and radiological extension. A negative mediastinoscopy makes it very unlikely that an inoperable cancer will be found. In bronchial carcinoma, mediastinoscopy is recommended whenever the risk attending excision of a tumor with lymph node involvement is to be weighed against the high operative risk in a debilitated patient. The usefulness of these exploratory procedures is enhanced by anterior mediastinotomy in cases with anterior tumor and in some left-sided bronchial cancers.

Adolescent↗
PubMed1982

Computed tomography versus aortography in diagnosis of aortic dissection.

The use of computed tomography (CT) versus aortography is evaluated in a limited study of 17 cases of aortic dissection (AD). With the constraints of the present state of the technology and lack of availability of CT scanners at some centers, aortography remains the premier and often the only diagnostic test to choose in an emergency. CT, however, may be an asset in the diagnosis of AD when: (1) atypical or misleading clinical presentations are evident that do not require aortography; (2) aortography is contraindicated in a weakened patient, when there is no emergency; (3) aortography is a risk while there is a strong suggestion of AD; (4) patency of a false channel must be confirmed. These circumstances were encountered in five patients. In addition, a localized infrarenal AD was fortuitously discovered in two patients presenting with abdominal visceral cancer. On patient follow-up, CT is less invasive and may be performed in asymptomatic patients undergoing treatment, thereby facilitating the early detection of complications. Detailed computed tomograms often yield superior diagnostic information only if the CT study includes rapid sequential scans immediately following a fast intravenous bolus of contrast material.

Aged↗
PubMed1982

[Esophageal perforation during tracheal intubation. Report on 6 cases. (author's transl)].

Perforation of the esophagus and hypopharynx followed tracheal intubation for general anesthesia or during intensive care in 6 patients. Circumstances favorable to the production of these lesions, and diagnostic features enabling early diagnosis are discussed. Simple surgical procedures and intensive postoperative care resulted in recovery in 5 of the 6 cases.

Aged↗
PubMed1982

[Vertebral arteriovenous fistula. Surgical technic by the paramedian posterior approach].

Description of an arterio-venous fistula of the suboccipital V3 portion of the vertebral artery in a male of 48. The first clinical manifestation of the fistula was a bruit following an injury, which had produced i.a. a mandibular fracture. For various reasons, the authors are of opinion that the fistula was rather congenital than traumatic. The technique of a paramedian surgical approach of the lesion is described. The authors think that this is a valuable procedure in the treatment of vertebral arterio-venous fistulas in the region between C2 and the foramen magnum.

Arteriovenous Fistula↗
PubMed1980

[Selective arterial embolization for haemorrhages complicating hip surgery. One case (author's transl)].

In a patient undergoing re-operation on the hip, the severity and repetition of haemorrhages despite successive blood transfusions led to therapeutic angiography. Angiography of the renal artery pinpointed the bleeding areas: pools of extravasated blood were found along the distal branches of the superior gluteal artery and the ascending branch of the posterior circumflex artery. Selective catheterization and embolization of these two vessels resulted in complete and permanent haemostasis. Arterial embolization, already widely used for post-traumatic haemorrhages, can therefore be applied to the haemorrhagic complications of orthopedic surgery. Provided it is sufficiently selective, the risks of extensive necrosis are non-existent.

Aged↗