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Biomedical subjects

J L Ferran

Publications and source records attributed to J L Ferran.

At least 19 recordsLinked to original sources
PubMed1998

Spiral twist of the spermatic cord: a reliable sign of testicular torsion.

BACKGROUND: Colour Doppler sonography (CDS) has become the procedure of choice in evaluating testicular perfusion but false negative findings have been reported. OBJECTIVE: To determine if direct visualisation of the twisted spermatic cord using high resolution US is a reliable sign to assess testicular torsion. MATERIAL AND METHODS: Thirty patients (aged 2-26 years) with equivocal diagnosis of testicular torsion prospectively underwent high resolution and CDS. The results were correlated with surgical findings. Serial transverse and longitudinal scans were performed to compare the scrotal contents on each side and study the complete spermatic cord course, from inguinal canal to testis, to detect a spiral twist. RESULTS: In 14 of the 23 cases of torsion, the diagnosis was based on the colour Doppler findings in the scrotum because blood flow was absent in the symptomatic testis and detectable without difficulty on the normal side. In nine cases, CDS was unreliable; in six cases intratesticular perfusion was present in a twisted testis and in three small boys, no colour signal was obtained in either testis. In all cases of torsion, the spiral twist of spermatic cord was detected at the external inguinal ring. The twist induced an abrupt change in spermatic cord course, size and shape below the point of torsion. It appeared in the scrotum as a round or oval, homogeneous or heterogeneous extratesticular mass with or without blood flow, that could be connected cephalad with the normal inguinal cord. In the other seven cases (three late torsions of the appendix testis, one epididymo-orchitis and three torsions with spontaneous reduction), no spiral twist was detectable. CONCLUSION: The detection of spermatic cord spiral twist appears a reliable US sign of torsion whatever the testicular consequences.

Adolescent↗
PubMed1996

Prenatal aspects of giant fetal cranial haemangio-endothelioma.

A case of a large vascular lesion of the skull is reported. The lesion was discovered at 22 weeks' gestation and it rapidly increased in size, reaching 8 cm a month later. Tumor echogenicity was the same as that for soft tissues and colour Doppler examination revealed intense vascularization. Cordocentesis showed features of the Kasabach-Merritt syndrome and very high plasma levels of alpha-fetoprotein. A Caesarean section was performed to avoid dystocia and led to the birth of a baby with cardiac failure in the immediate neonatal period. Biopsies of the mass led to the diagnosis of a non-malignant haemangio-endothelioma. The mass was removed and plastic surgery performed. The baby is alive and well 9 months after the operation.

Adult↗
PubMed1996

Atypical pyloric stenosis in an infant with familial hyperlipidemia.

A 1-month-old infant presented with a typical pattern of pyloric stenosis but US revealed an intense hyperechogenicity of the thickened pyloric muscle. Cholecystitis and pancreatitis were also present in this child. Familial hyperchylomicronemia was detected. Surgery confirmed the fatty infiltration of the pyloric muscular layer, which was necrotic and inflammatory. Medical management with restriction of fat in the diet led to a complete recovery. This is an exceptional case of pyloric stenosis where the particular echographic appearance of the pyloric muscle led to successful to medical treatment.

Humans↗
PubMed1993

Prenatal diagnosis of diastematomyelia.

Fetal diastematomyelia, a malformation due to a longitudinal split of the cord, was diagnosed during the third trimester. Diagnosis was based on the visualization of a sagittal bony spur in the thoracolumbar spinal canal, associated with enlargement of the canal, hemivertebrae and spina bifida without a meningocele.

Adult↗
PubMed1990

[Three-dimensional analysis of the hip during growth].

Ultrasonography provides a genuine breakthrough in the diagnosis of congenital dislocation of the hip and also helps considerably in evaluating the evolution and treatment. Current tridimensional analysis techniques, as described in this article, have revolutionized imaging. Operative situations may be simulated by a computer. Congruence, concentricity and coverage of the head may be evaluated.

Child↗
PubMed1985

[Enterolithiasis and digestive duplication. Apropos of a pediatric case].

This is the case report of a 13 years old white young girl in whom numerous moving abdominal calcifications are discovered during investigation for chronic anemia. Because of the existence of a severe vascular malformation of the face, a digestive arteriography is performed with no evidence of a calcified angiomatosis of the intestine tract. Preoperative diagnosis was intestinal duplication with enterolithiasis. Exploratory laparotomy confirmed that it was a huge communicating ileal duplication with numerous intestinal calculi and alimentary fragments. Surgical excision was easy and post-operative course, uneventful. This is a standard association but never reported in the pediatric literature. The authors stress on the different diagnosis of calcifications encountered in abdominal X rays in children and on chronic intestinal stasis which is the main factor in enteroliths formation.

Adolescent↗
PubMed1985

[Spasticity of the lower limbs and the Weaver-Smith syndrome].

The diagnosis of Weaver-Smith syndrome has been carried out on two patients with facial dysmorphic features, excessive growth and accelerated bone maturation. A marked spasticity of the lower limbs with joint contractures in one patient, a spastic quadriplegia with delayed milestones in the second patient were the most prominent clinical features. In both cases a spontaneous improvement of muscle tone with complete recovery was observed at the end of the first year of life.

Bone Diseases, Developmental↗
PubMed1981

[Ultrasonography of an aneurysm of the great vein of Galien (author's transl)].

In a 15 day-old infant who presented with heart failure on the 4th day of life, the discovery of a continuous murmur at the level of the cranium led to suspicion of an aneurysm of the vein of Galien. Chest and neck profile X-rays showed an enlargement of the great vessels at the base of the heart and a thickening of the retropharyngeal soft tissues. Cerebral echotomography through the fontanelle showed an anechoic round area located in the posterior part of thalamus. Cerebral angiography confirmed the diagnosis.

Angiography↗
PubMed1981

[Ultrasonography before surgical operation of retroperitoneal malignant tumors in childhood (author's transl)].

Abdominal tumors in childhood are diagnosed almost always by palpation only, the retroperitoneal localization of these are confirmed by I.V.P. The new gray scale ultrasound machine seem to be very useful in the staging of the masses before the surgical operation. For the correct appreciation of the sensibility of gray-scale ultrasound, 6 Wilm's tumors, 6 neuroblastoma and 1 malignant retroperitoneal fibroma were reviewed. These children were echographied just before the surgical procedure and the surgeon's reports were compared with ultrasonics findings. If the sensibility is good to give measurement of the masse and to establish the situation of the tumor toward the midline of the abdominal cavity, the visualisation of the great vessels was not so obvious. However these hepatic structures were well established in all cases. The renal vein was never seen. At the end of this report it's possible to describe differential echographic findings between Wilm's tumor and neuroblastoma. --A Wilm's tumor is a mass well limited in periphery, confused with the kidney and with a frequent sonolucent rim sign. --A Neuroblastoma is a very irregular tumor well separated of the kidney without sonolucent area in its limit. U.S. made after an I.V.P. is in all cases very useful to surgeons. The two methods with their additional findings make almost always arteriography without interest.

Adolescent↗