PubMed Health⌕ Search

Biomedical subjects

J M Bouret

Publications and source records attributed to J M Bouret.

17 recordsLinked to original sources
PubMed1997

[Recourse to particular arterial embolization in the treatment of some uterine leiomyoma].

UNLABELLED: In 88 women between the ages of 34 and 51 years with one or several symptomatic uterine leiomyomata (menometrorrhagia, mass syndrome) after failure of medical treatment, particulate arterial embolization was proposed as an alternative to the scheduled surgical operation. Free-flow embolization with Ivalon particles (150 to 600 microns) was performed under local anaesthesia after femoral artery puncture and catheterization of the hypogastric then uterine arteries (5 F catheter) including occlusion Pelvic pain was frequently observed immediately after embolization, lasting 12 to 18 hours, and required analgesia. Necrobiosis syndromes can be observed in the case of very large leiomyomata. No immediate complications directly related to vascular catheterization were observed in this series, but complete necrosis of a very large leiomyomatous uterus required hysterectomy. Five embolization failures were observed. The following results were observed in the 80 interpretable cases with a follow-up of 6 to 60 months: the menstrual periods returned to normal in 60 (89%) of the 67 menorrhagic patients, after six months a volume reduction of myomata equal to 69% of initial volume was observed. CONCLUSION: in of 80 interpretable cases, embolization constituted an alternative to surgical treatment, which was avoided in 71 cases, 9 failures were observed. The results of this preliminary series must be valited by further studies.

Adult↗
PubMed1996

Place of emergency arterial embolisation in obstetric haemorrhage about 16 personal cases.

Delivery bleedings which persist despite of an efficient medical treatment must be offered embolization without delay. Embolization is efficient in nearly 100% of cases; sometimes it has to be repeated. Embolization will it correct coagulopathy in few hours. It is a conservative treatment. It is nowadays undoubtedly the treatment of choice. Territorial organization for the hospital without interventional radiology is needed to organize the transfer of the bleeding patients without delay. Thus, mortality and morbidity as well as hysterectomy will not exist anymore.

Embolization, Therapeutic↗
PubMed1996

[Carbon dioxide embolism during hysteroscopy followed by transient blindness].

A 43 year-old woman, with uterine bleeding and right ovary cyst, was scheduled for hysteroscopy-curettage and laparoscopy. Her history was unremarkable. After induction of general anaesthesia and tracheal intubation (propofol, fentanyl, vecuronium), anesthesia was maintained with N2O/O2 (60%/40%) and isoflurane 1 vol %. The patient was placed in the dorsal lithotomy position. Two minutes after the beginning of CO2 insufflation for hysteroscopy, a ventricular tachycardia with a circulatory arrest suddenly occurred. Insufflation was stopped, cardiopulmonary resuscitation started and lignocaine 100 mg iv administered. The haemodynamic status improved rapidly with a return to sinusal rhythm and stable blood pressure within two minutes. In the recovery room, the patient was restless and experienced blindness for 3 hours. Physical examination and all investigations (EEG, brain CT scan, carotid Doppler and transoesophageal echocardiography) were normal. The most probable diagnosis was a CO2 venous embolism associated with an arterial paradoxal embolism responsible for the temporary blindness.

Adult↗
PubMed1996

[Umbilical metastasis of an endometrial adenocarcinoma: "Sister (Mary) Joseph's nodule". Review of the literature].

In the beginning of the XXth century, Sir Hamilton Bailey proposed the name "Sister Joseph's nodule" for the umbilical metastasis of an abdominal cancer. This unusual pathology has multiple primitive etiologies. We report here the 27th case of an umbilical metastasis of an endometrial adenocarcinoma. In case of a malignant umbilical tumor, 75% correspond to a "Sister Joseph's nodule". Their clinical manifestations are quite similar. This secondary localisation could appear before, during or after the diagnosis of the primitive tumor. Adenocarcinoma is the frequently diagnosed histological type. The endometrial origin represents only 1.4% of the cases. Multiple routes of spread exist. Prognosis remains poor. Medico-surgical treatment, in a curative target, will be aggressive and should be adapted at every case. Our case-report recalls a new patho-physiological approach. The extended follow-up of this patient, without further medical treatment, is an additional argument.

Adenocarcinoma↗
PubMed1995

Arterial embolisation to treat uterine myomata.

Haemorrhage, probably related to hypervascularisation, is the commonest complication of uterine myomata and is difficult to treat. 16 patients, aged 34-48 years, with symptomatic uterine myomata, for which a major surgical procedure was planned after failure of medical treatment, were treated by selective free-flow arterial embolisation of the myomata with Ivalon particles. With a mean follow-up of 20 months (range 11-48) in the responders, symptoms resolved in 11 patients; menstrual cycles returned to normal in ten of these. Three patients had partial improvement. Two failures required surgery. In 14 cases embolisation caused pelvic pain, which required analgesia in all.

Adult↗
PubMed1995

[Pneumoperitoneum related to celioscopy. Prevention of vascular wounds].

The insertion of the inflation needle during laparoscopic procedures carries the risk of severe vascular damage to the aorto-cava bifurcation. Interindividual anatomic variation is great as shown by magnetic resonance imaging, increasing the risk of vascular damage. Four simple technical precautions are recommended to prevent accidents: insertion at the lower umbilical margin, widen distance between the umbilicus and the greater vessels, a 45 degree insertion angle and strictly medial position.

Aorta, Abdominal↗
PubMed1993

[Screening for ovarian cancers: critical analysis].

The ovarian cancers have a low incidence rate and a high mortality rate mainly due to a late diagnosis. The potential value of ultrasonography and measurements of tumour associated markers to detect early ovarian cancer suggest the interest of a screening strategy. The analysis of the conditions for efficacy of a such screening program, of the predictive values of ultrasonography and tumour associated markers measurements and of the results of preliminary studies does not confirm on a rational basis the potential interest of screening strategies.

Adult↗
PubMed1993

[Obstructive myocardiopathy and pregnancy].

We report a case of pregnancy in a patient with severe obstructive cardiomyopathy treated with beta-blockers. A review of the literature shows that in spite of possible worsening of the functional symptomatology, pregnancy does not increase the risk of mortality. The recommendations for the conduct of the delivery are reviewed. The risks for the fetus are essentially linked to the treatment with beta-blockers and the possibility of inheritance of the condition.

Adrenergic beta-Antagonists↗
PubMed1992

[Breast nodule].

Explore the source record for details and available documents.

Adult↗
PubMed1992

[Associated rectal and genital prolapse: value of Delorme's operation. A case report].

Rectal prolapse is a rare disorder, which usually affects patients suffering from genital prolapse (rectal prolapse is associated with genital prolapse in 50% of cases). On the basis of a study of the literature and with regard to one case history, the authors set out to explore the simplest and most effective way of treating these two disorders simultaneously. The treatment remains surgical and should combine treatment of the genital prolapse by vaginal route with treatment of the rectal prolapse by means of the Delorme operation. The mortality and morbidity rates are zero if this operation is used and the relapse rate is only 8 to 11% for the rectal prolapse. It would appear that the two approaches are rarely associated by the authors and would seem to be interesting to reconsider this question by indicating mixed treatment of the two prolapses whenever possible.

Aged↗
PubMedDate not supplied

[Indications and results of autotransfusion. Normovolemic hemodilution in gynecology-obstetrics].

Considering the importance of haemorrhagic complications in gynaecology-obstetrics and the increasing fear of accidents during blood transfusion, the authors propose, from the literature and the study of 13 cases, a reflection on the indications of deferred autotransfusion (DAT) and of normovolemic haemodilution (NVH). In obstetrics, even if DAT has undoubtedly certain advantages (besides viral contaminations, appearance of allo-antibodies...), it can be indicated at present only for pregnant women exposed to a predictable risk of haemorrhage or for women with a rare blood group. In gynaecology, the authors have not found any significant advantages in our study as regards NVH associated with DAT. However, as in obstetrics, the technique is harmless, and no thrombo-embolic complications have been observed, even in women at high thrombotic risk. These methods are expensive and require qualified personnel. Their exact modalities and indications, as well as their medico-legal aspects, are yet to be defined.

Adult↗