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Biomedical subjects

M F Ladeb

Publications and source records attributed to M F Ladeb.

At least 19 recordsLinked to original sources

[Splenic nodules and sickle cell anemia].

OBJECTIVE: We report 4 patients with sickle cell anemia presenting with intra-splenic benign nodules corresponding to islands of preserved tissue within splenic ferro-calcinosis. MATERIAL AND METHODS: Ultrasound, CT and MRI findings were evaluated and compared to a follow-up study by ultrasound and CT done after 6 to 12 months. RESULTS: Ultrasound showed multiple well-defined rounded nodules appearing hypoechoic compared to the rest of the spleen that was hyperechoic. On CT, the nodules were homogenous, hypodense relative to the spleen, isodense to the liver in 3 cases and hypodense to the liver in 1 case. On MRI, the nodules appeared relatively hyperintense within low-signal-intensity spleens. The ultrasound and CT follow-up study demonstrated no remarkable change. CONCLUSION: In sickle cell patients, intra-splenic benign nodules corresponding to normal splenic tissue may be identified on imaging studies. The differential diagnosis is discussed.

Abdominal Pain↗

[Non-vascular retroperitoneal emergencies].

Acute renal disease, in the absence of trauma, consist of acute renal obstruction, renal infection or a combination of the two. The diagnosis of acute renal colic is usually performed with ultrasound or excretory urography whereas parenchymal involvement in renal infection is best demonstrated on computed tomography images. The aim of radiologic investigations is to look for complications in order to guide the treatment, particularly percutaneous procedures. Other less common acute renal diseases include renal vein thrombosis optimally analyzed with contrast injection to demonstrate renal function, and spontaneous renal hemorrhage, which implies careful renal assessment looking for a small tumor. Acute psoas compartment diseases include hematomas and abscesses. Computed tomography is the best diagnostic tool and the examination of choice for the follow-up lesions and to guide percutaneous drainage.

Acute Disease↗

[Retroperitoneal vascular emergencies].

Ruptured abdominal aortic aneurysm is the major surgical emergency in the retroperitoneal compartment. Rupture of an abdominal aortic aneurysm is always fatal without urgent operative repair. Computed tomography is the reference standard for the diagnosis of ruptured abdominal aortic aneurysm in hemodynamically stable patients. At CT, the diagnosis is based on the combination of abdominal aortic aneurysm and extraluminal retroperitoneal blood. Retroperitoneal hemorrhage usually demonstrates both isodense and hyperdense areas. In most cases hemorrhage is located in psoas compartments and perirenal space. In the case of ruptured abdominal aortic aneurysm other findings may be demonstrated such as focal interruption of the aortic wall and active extravasation of contrast media in the retroperitoneal compartments. Inflammatory abdominal aortic aneurysm, that may present as acute abdominal pain, should be recognized and differentiated from ruptured abdominal aortic aneurysm. Inflammatory abdominal aortic aneurysm is characterized by a fibrotic process around the abdominal aorta that may entrap adjacent structures such as ureters, duodenum and inferior vena cava. Aortic dissection, mycotic aneurysm, and inferior vena cava thrombosis are less common. Complications occurring after emergency aneurysm replacement are also considered.

Adult↗

[Intraperitoneal vascular emergencies].

Intraperitoneal vascular lesions constitute severe causes of acute abdomen. These disorders include ischemia and infarction of colon and small bowel and abdominal hemorrhage. In case of intestinal ischemia, the radiologic procedures are performed in order to establish the diagnostic, identify the site of ischemia, and detect the etiology of ischemia. Plain radiography of the abdomen, ultrasonography, CT scan and angiography may be performed. In case of intestinal hemorrhage, angiography may be performed when endoscopy fails to establish the diagnosis. Embolization can be performed in selected cases.

Adult↗

[Acute pancreatitis].

The diagnosis of acute pancreatitis is based on clinical examination and basic laboratory tests. The main role of sonography in acute pancreatitis is to evaluate gallstones and small fluid collections. However, sonography is frequently difficult due to intestinal ileus related to pancreatitis. CT is indicated early in the clinical course of acute severe pancreatitis when the diagnosis is uncertain or when complications such as abscess, hemorrhage, or necrosis, are suspected. In addition, CT may be used to assess the prognosis and follow-up of patients.

Acute Disease↗

[Abdominal injuries].

Radiologic evaluation of abdominal trauma must provide a quick and accurate assessment of the lesions in order to improve the management of the patient. The technique used varies depending on the mechanism of the trauma (blunt trauma or stab wounds) and the hemodynamic status. Radiologic evaluation is usually performed in blunt trauma whereas stab wound trauma is usually explored surgically. The various techniques available are standard radiographs, ultrasonography, computed tomography and arteriography. The role of magnetic resonance imaging in the immediate evaluation is still not well defined. It appears to be a useful method in the delayed evaluation of diaphragmatic trauma. Computed tomography is the method most commonly performed in trauma patients. This technique is accurate and allows correct assessment of the lesions. The disadvantages are the radiation induced and the need for a hemodynamically stable patient. The aim of the radiologic evaluation is to provide the clinicians with an accurate description of the lesions. It can help in the management of the patient usually in association with clinical and laboratory data. It can also guide interventional procedures (drainage, embolization...). Finally, it allows radiographic follow-up when conservative treatment is performed.

Abdominal Injuries↗

[Thoraco-abdominal digestive duplication].

The authors report a case of a thoraco-abdominal duplication of the foregut, observed in a 10-year old boy. Thoraco-abdominal duplication is an expression of notochordodysraphia, as it is frequently associated with vertebral malformations. Barium meal, ultrasonography and CT-Scan should provide a preoperative diagnosis. One-stage total excision in a single stage is mandatory in order to treat the symptoms and avoid the risks of further progression.

Cardia↗

[Mondini's malformation. Apropos of a case].

Mondini's malformation is a rare internal ear malformation. It's often discovered in childhood in the course of perception deafness check up, or repetitive meningitis in some other cases. The authors report a case of complex Mondini's malformation with fistulas of cerebro-spinal-fluid in oval and round windows, and stress the interest of high resolution computed tomography.

Cerebrospinal Fluid Otorrhea↗

[Non-surgical treatment of kidney abscesses. Apropos of 12 cases].

Twelve renal abscesses were treated with percutaneous aspiration (6 patients), percutaneous drainage (3 patients) or antibiotics alone (3 patients). The diagnosis was established based on computed tomography-guided aspiration in 9 cases and on radiographic findings and follow-up in the remaining 3. A bacterium was isolated in 2 out of 9 blood cultures, 2 out of 11 urine cultures and in all cultures of pus obtained by percutaneous aspiration. All patients had a good outcome. Our findings confirm the efficacy of percutaneous aspiration in the treatment of renal abscesses. Percutaneous drainage should only be considered when the abscess is very large or aspiration has failed.

Abscess↗

[Bone hydatidosis. 12 cases].

The hydatic cyst is a parasitic disease caused by the development in man of the larval form of echinococcus granulosus. All parts of the body may be involved, but the liver and lungs are the main locations of the disease. The bone site is rare, accounting for 0.9 to 2% of all hydatic lesions. Between 1982 and 1988, we have compiled 12 cases of hydatic disease of bone. They were located in the skull (4 cases), the iliac bone (4 cases), the omoplate (1 case), the ribs (1 case), the femur (1 case) and the fibula (1 case). These lesions are generally considered as primary, but association with visceral locations was noted in 3 cases in our series.

Adult↗

Cerebral candidiasis. Computed tomography appearance.

A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodeficiency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature.

Brain Diseases↗

[Thrombophlebitis of the ovarian vein. Apropos of 2 cases].

Thrombophlebitis of the ovarian vein is a rare post-partum complication. Its diagnosis is said to be difficult, but was greatly facilitated by the progress made in imaging. The authors report about two cases identified with computed tomography. Evolution was favorable in both cases with an anticoagulant and antibiotic treatment.

Abdominal Pain↗

[Pelvic hydatidosis in women. Apropos of 3 cases].

In 80 to 90% of cases, hydatid disease affects the liver and the lung. In only 2% of cases is it localised in the pelvis. On the clinical level there is no specific sign of pelvic hydatid disease. The diagnosis used to be difficult but it has become easy, thanks to modern methods of imaging. The authors report 3 cases that were diagnosed by ultrasound and tomodensitometry. Surgical removal, which was carried out in each case without difficulty, was successful. They review the ultrasound and tomodensitometry pictures of hydatid disease and the principles of its surgical treatment.

Adolescent↗