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Biomedical subjects

M A Bruhat

Publications and source records attributed to M A Bruhat.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Spontaneous hematoma of the liver in pregnancy: non-surgical treatment. Favorable outcome apropos of a case].

The authors report a case of spontaneous rupture of the liver during pregnancy which occurred in a 31-year old multiparous woman with pre-eclampsia. In the literature, this rare event is associated with both maternal and fetal high mortality rates. Histopathological studies have shown periportal parenchymal lesions, larger sinusoidal fibrin deposits and hemorrhagic infarctions. Our case was successfully managed with termination of pregnancy by cesarean section without surgical procedure toward subcapsular hematoma. Long term follow-up using liver scans is needed.

Adult↗
PubMed1989

Treatment of acute salpingitis with sulbactam/ampicillin.

The combination of sulbactam/ampicillin was compared to cefoxitin for the treatment of acute salpingitis in 40 women divided into two groups of 20 women each. There were 11 patients in each group who were given doxycycline because of evidence of chlamydial infection. All patients were diagnosed by laparoscopic examination and evaluated by the same procedure 7-12 weeks later. At the second laparoscopy, only 1 of the 20 patients (5%) treated with sulbactam/ampicillin had severe adhesions, while 6 of the 20 patients (40%) treated with cefoxitin had severe adhesions. Tubal patency was without obstruction in 14 patients (70%) given the combination treatment and in 12 patients (60%) given cefoxitin. Side effects were essentially absent in both groups.

Acute Disease↗
PubMed1989

Laparoscopic management of adnexal torsion. A review of 35 cases.

Laparoscopic management was used for 35 cases of adnexal torsion. Since early diagnosis and treatment are necessary to preserve the adnexa, laparoscopy is the best procedure for diagnosing this rare condition. In 27 cases (77%) conservative treatment was carried out, with only 1 recurrence. Complete laparoscopic treatment was achieved in 27 cases (77%), including 3 of endoscopic salpingectomy. Laparotomy was indicated in cases of gangrenous adnexa, organic ovarian cyst and unusual ovarian attachment.

Adnexal Diseases↗
PubMed1989

Laparoscopic treatment of endometriosis.

Adequate management of endometriosis by laparoscopy included 3 steps: a laparoscopic diagnosis with peritoneal fluid sampling for cytologic examination and biopsies of implants and of peritoneum to assure a correct diagnosis, a laparoscopic evaluation of extension with the American Fertility Society (AFS) 85 scoring system in order to classify the severity of the disease, and a laparoscopic treatment with the following strategy: drainage of the ovarian endometrioma and careful peritoneal washing, treatment of peritoneal implants, ovariolysis, treatment of the ovarian cysts, hemostasis and peritoneal lavage. Treatment of peritoneal implants is very easily performed by CO2 laser vaporization using a suprapubic puncture. Ovarian endometriomas are treated by laparoscopic cystectomy using a transparietal cystectomy or an intraperitoneal cystectomy. Laser vaporization is used only in case of small ovarian cysts or after an incomplete resection of a large cyst. Results of laparoscopic treatment of endometriosis compare favorably with those obtained with surgical procedures performed by laparotomy with the well known advantage of a laparoscopic approach.

Adult↗
PubMed1989

[Magnesium and the threat of premature labor].

The magnesium ion, which is a bivalent cation and is necessary for life, is a co-factor in more than 300 enzyme reactions. It has an action on uterine myometrium causing it to relax by stimulating B2 adrenergic receptors and cyclical AMP. It competes with the calcium ion which brings about inhibition of myosine kinase, and therefore a drop in phosphorylated myosine. Deficiency of magnesium is one explanation for uterine overactivity; because it is difficult to estimate how important it is in certain premature labours because this is caused often by many factors, and the levels of plasma magnesium and of blood cell magnesium give poor information about the magnesium pool. The tocolytic properties of magnesium are interesting. One has to distinguish between oral magnesium-therapy, given as a preventive from the first trimester of pregnancy, and parenteral magnesium therapy which can be curative and which, like beta-mimetics, is indicated in threatened premature delivery.

Female↗
PubMed1988

[Decrease of HCG level after conservative laparoscopic treatment of extra-uterine pregnancy].

HCG levels have been studied in 76 patients following laparoscopic treatment using laparotomy. This shows that early detection of treatment failure is possible of ectopic pregnancy. The decrease of HCG was the same as after conservative treatment from the third or fifth post-operative day onwards. The authors report a scheme for the post-operative follow-up after laparoscopic treatment of ectopic pregnancy based on the rate of HCG decrease.

Chorionic Gonadotropin↗
PubMed1988

[Spontaneous hepatic hematoma during pregnancy].

Spontaneous hepatic haemorrhage is a rare complication in pregnancy. It usually occurs in multiparous women who have toxaemia of pregnancy. We give a case history of a primigravid patient who was not toxemic. The hepatic haemorrhage presented as blood in the peritoneal cavity which in turn gave rise to abdominal pain with hypovolaemic shock. The surgical treatment consisted in removing the segment of the liver that had been bleeding. The physiopathology of hepatic haemorrhage as described in the literature shows that there was evidence of consumptive coagulopathy with coalescence of periportal areas of liver necrosis. Treatment therefore is that of hepatic trauma. Maternal mortality runs at 70%.

Adult↗
PubMed1987

CO2 laser microsurgery: five years experience with long-term results.

Techniques and results of CO2 laser microsurgery are reported from a series of 123 patients operated on between 1979 and 1983. Salpingostomy was carried out in 76 patients, reversal of sterilization in 16 patients, reanastomosis for pathologic disease in 12 patients, and combined procedures in 19 patients. Results compare favorably with conventional microsurgery. CO2 laser surgery appears to be a very effective technique and is very easy to achieve in microsurgery. Correct use of CO2 laser is required in order to obtain a good post-operative success rate. The surgeon must be competent in microsurgery and in laser technology.

Adult↗
PubMed1987

[Decrease in HCG levels after conservative laparoscopic treatment of extra-uterine pregnancy].

Dropping hCG levels have been studied in 76 patients following laparoscopic treatment of ectopic pregnancy. The drop in hCG is the same as after conservative treatment using laparotomy. This study shows that early detection of treatment failure is possible from the third or fourth post-operative day onwards. The authors report a scheme for the post-operative follow-up after laparoscopic treatment for ectopic pregnancy relying on the hCG rate.

Chorionic Gonadotropin↗
PubMed1987

[Ovarian cysts and celioscopy. Apropos 226 cases].

Tumours of the adnexae are frequent. In most cases it is necessary to look at them directly and to treat them surgically. Laparatomy is a heavy technique. For this reason we use the laparoscope to diagnose cystic lesions and to treat benign tumours. This retrospective study on 226 patients has given us the opportunity to assess the value of the laparoscope in these conditions. From the diagnostic point of view laparoscopy is reliable. No malignant tumour failed to be diagnosed (100% reliable), the anatomopathological examination of specimens in benign conditions was never wrong (100% reliable). Laparoscopy therefore is a reliable way of diagnosing the type of ovarian cyst. 180 patients were treated using the laparoscope (79.5%). The patients were followed up for 1 to 5 years. We have not had a recurrence of a cyst treated in this way. Each time a malignant tumour was diagnosed or even suspected the classical surgical approach by laparotomy was always carried out. For a trained surgeon laparoscopy seems to be a reliable method of diagnosing and treating. It possesses the very well-known advantages of minimal operative trauma and far less cost.

Adolescent↗