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Biomedical subjects

M Bretagnolle

Publications and source records attributed to M Bretagnolle.

At least 19 recordsLinked to original sources
PubMed1988

Hepatocellular carcinoma: diagnosis by percutaneous fine needle biopsy.

One hundred fifty-nine cases of hepatocellular carcinomas (HCCs) were reviewed from a series of 1060 cases of percutaneous fine needle biopsies of the liver. The biopsies were performed under ultrasonic guidance using a 22-gauge needle with a beveled tip. Specimens were obtained from the lesion and from areas of normal-appearing liver for comparison. Two sets of slides were prepared for Papanicolaou and Giemsa staining. In 147 cases (92%), the diagnosis of malignancy was established. In 134 cases (84%), the specific diagnosis of HCC was made. Fifty-four percent of the HCCs were well differentiated without cytonuclear abnormalities. In these cases, the diagnosis was made by comparison of specimens from the tumor with those obtained from the normal liver. Thirty-seven percent of the HCC were moderately differentiated with cytonuclear abnormalities. Nine percent of the HCCs were poorly differentiated, and in these cases, identification of glycogen on periodate-Schiff's procedure staining permitted differentiation from a metastatic tumor. In 9 cases, the aspirate was inadequate: there was insufficient tissue in 3 cases and the lesion was missed in the 6 other cases. In 3 cases, a biopsy of normal liver was not obtained and the diagnosis of HCC could only be suspected. Significant bleeding after biopsy occurred in 4 of 1060 cases, all with HCC.

Biopsy, Needle↗
PubMed1988

Percutaneous aspiration and drainage of hydatid cysts in the liver.

Percutaneous aspiration of hydatid cysts of the liver was performed in 13 patients, and subsequent percutaneous drainage was performed in three of the 13. Aspiration was performed with ultrasound or computed tomographic guidance with 22-gauge to 19-gauge needles. Analysis of the aspirated specimen established the diagnosis of hydatid cysts in nine of the 13 patients. Fragments of the laminated membrane were seen in seven cases, scolices in two cases, and hooklets in two cases. In the four cases with negative results on aspiration, the diagnosis was established with surgical findings in one case and unequivocal immunologic results in three cases. In two patients, a mild allergic reaction with temporary pruritus was observed. In three patients, percutaneous drainage was performed with a 5-F to 8.3-F catheter, and sterilization of the cyst was achieved by injection of a scolicidal agent. No complications occurred at the time of drainage, and no recurrences developed during 6 months to 1 year after drainage.

Adult↗
PubMed1987

Obstructive jaundice by a dissecting aneurysm of celiac axis and hepatic artery.

We report a case of dissecting aneurysm of the celiac axis and hepatic artery resulting in obstructive jaundice. The aneurysm was demonstrated both by ultrasound and by angiography, but the associated aortic dissection was apparent only on CT scan. The patient was treated with percutaneous transhepatic biliary drainage, surgical exclusion of the aneurysm by ligation, and progressive dearterialization of the hepatic artery.

Aortic Dissection↗
PubMed1987

Evaluation of a combined percutaneous-endoscopic procedure for the treatment of choledocholithiasis and benign papillary stenosis.

In 19 patients suffering from choledocholithiasis or papillary stenosis, retrograde cholangiography or sphincterotomy failed because of anatomic abnormalities. In such cases, sphincterotomy was then performed with the assistance of a percutaneous catheter. Two complications were observed: moderate bleeding from the transhepatic drain, and a retroperitoneal perforation needing surgery. This combined procedure is very efficient, but gives rise to complications of both the transhepatic and endoscopic routes.

Aged↗
PubMed1987

Pancreatic duct: US-guided percutaneous opacification.

Percutaneous pancreatography was attempted in 28 patients. In 18 cases, the examinations were performed after failure of endoscopic retrograde cholangiopancreatography (ERCP); in ten patients, ERCP was not attempted. Under real-time ultrasonic guidance, a 22-gauge needle was inserted into the pancreatic duct, which ranged in size from 3 to 15 mm. After aspiration of pure pancreatic juice, 10-20 ml of contrast medium was injected under fluoroscopic control. The examination was successful in 25 patients. The only significant complication was bile leakage in a patient with obstructive jaundice. Of the six patients who subsequently underwent surgery, evidence of the puncture site was present in only one.

Humans↗
PubMed1986

Use of large silicone catheters in patients with long-term percutaneous transhepatic biliary drainage.

In 30 patients with inflammatory bile duct stenoses or slow-growing tumors of bile ducts, 12-18 F silicone catheters were placed with a percutaneous transhepatic approach in order to provide a more efficient and comfortable internal-external drainage. The main advantages were the large variety in size, improved flow, and softness of the catheter. However, because of the absence of distal tapering, the tubes had to be inserted several days after the initial drainage, when a tract was formed through the liver.

Bile↗
PubMed1986

Abdominal lesions: a prospective study of clinical efficacy of percutaneous fine-needle biopsy.

A prospective study was undertaken to assess the contribution of percutaneous fine-needle biopsy (PFNB) to the diagnostic workup and therapeutic management of 112 abdominal lesions in 106 patients (69 hepatic, 27 pancreatic, and 16 nondetermined). In 75% of the patients, PFNB contributed significantly to the diagnosis, in 22% it was of little help, and in 3% it confused the diagnosis. It confirmed a highly suspected diagnosis in 55% of patients and indicated a specific diagnosis that was not suspected in the remaining 45%. Results of PFNB guided treatment in 32% of cases, increased confidence in a previously planned therapy in 39%, and did not alter therapy in 29%. PFNB was instrumental in avoiding 61 planned invasive investigations and 11 surgical explorations, with a cost savings of about 35%. No significant complication was observed after PFNB.

Abdominal Neoplasms↗
PubMed1986

Unsuspected pheochromocytoma: risk of blood-pressure alterations during percutaneous adrenal biopsy.

Four unsuspected pheochromocytomas were discovered during percutaneous fine-needle biopsy of the adrenal gland under ultrasound (n = 1) and computed tomographic (n = 3) guidance. One patient suffered an acute episode of alternating hypertension and hypotension during the procedure. A second patient had no alterations in vital signs during the procedure but had a severe hypertensive crisis during induction of anesthesia at surgery. Neither biopsy nor surgery affected the vital signs in the other two patients. During biopsy study of adrenal lesions, the possibility of unsuspected pheochromocytoma should be considered, and the interventional radiologist must be familiar with the emergency treatment of hypotensive or hypertensive crises that may occur.

Adrenal Gland Neoplasms↗
PubMed1986

Ultrasonically guided fine-needle biopsy in focal intrahepatic lesions: six years' experience.

We report the results of 322 ultrasonically guided percutaneous fine-needle biopsies of focal intrahepatic lesions. The technique is original in several respects; it is an aspiration of both the lesion and normal-looking liver, and it includes both cytology and histology when the tiny cores are obtained. Cytology included Papanicolaou and Giemsa staining and other special staining when necessary. Sensitivity was 88.6% and specificity was 100% in the diagnosis of malignancy. Out of 141 metastases, 14 false negatives, 5 misclassifications, and 122 correct diagnoses were obtained. Out of 69 hepatomas the correct diagnosis of malignancy was made in 63 patients and of these the correct classification in 49. Complications occurred in six patients and marked hemorrhage in four. This technique is a simple, accurate, safe method for the diagnosis of focal intrahepatic lesions.

Biopsy, Needle↗
PubMed1985

Small, asymptomatic angiomyolipomas of the kidney.

Ultrasound (US) detected 27 small, asymptomatic renal angiomyolipomas in 18 patients. Twenty-five lesions were diffusely hyperechoic and 2 were heterogeneous. Nephrotomography was positive in 8 out of 12 patients (67%), CT in 12/14 (86%), and angiography in 10/14 (71%). Percutaneous fine-needle biopsy confirmed the diagnosis in 8 out of 12 patients (67%). Nephrotomography and angiography were nonspecific, whereas CT and biopsy were most specific because of the presence of fatty tissue. Angiography helped clarify the degree of vascularity of the masses. If the diagnosis can be made preoperatively, more conservative management can be undertaken.

Adolescent↗
PubMed1985

Ultrasonic features of aneurysms of splanchnic arteries.

A review of nine patients with aneurysms of the splanchnic arteries was undertaken. The records and the sonographic findings were analysed. Seven of the nine aneurysms could be diagnosed ultrasonographically. The aneurysm appeared as a round hypoechogenic nodule connected to or in close relation with the feeding artery. In four patients the lesions were incidentally detected and two of them were operated upon because of a risk of spontaneous rupture.

Adult↗