Acute renal failure due to bilateral ureteral hematomas complicating anticoagulant therapy.
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Biomedical subjects
Publications and source records attributed to O Bacques.
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Venous thrombosis of the upper limb is classically rarely complicated by pulmonary embolism. The authors report a case of phlebitis of the upper limb in a 46-year-old woman with a thoracic outlet syndrome complicated by multiple and recurrent pulmonary emboli. Analysis of recent data from the literature would appear to bring into question the classically accepted harmless nature of this condition regarding the risk of embolic complications.
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The presence of a lupus anticoagulant (LA) is paradoxically associated with a high incidence of arterial and venous thrombosis. In a patient with a lupus-like systemic disease, having received phenindione for 11 years, LA was discovered in association with recurrent deep venous thrombosis, a right atrial thrombus, coronary occlusion, arterial hypertension, thrombopenia, and anticardiolipin antibodies without anti-DNA antibodies. Renal cortical ischemia was detected by a tomographic scan. Renal biopsy showed glomerular ischemia and diffuse interstitial fibrosis. After a one-year anticoagulant and steroid therapy, LA has disappeared despite a high level of anticardiolipin antibodies, and renal function remains normal.
Immobility in intravenous digital angiography (ANIV) plays a leading part for high-quality results. Three hundred forty children (mean age 30 months, mean weight 12 kg) had an intravenous digital angiography in day-hospital's conditions. Intravenous general anesthesia with or without short neuromuscular blockade is able to help immobility in children. Method described requires a perfect synchronization with the radiologist. Anesthesia mean life was 6 minutes. No incident or fatal accident was observed. Many observations either confirmed the diagnosis or decided a surgical intervention. Determinant character of obtained investigations incite us to accept risks inherent in the technique.
Ultrasound imaging should be carried out in all children with posterior basal lesions of lungs suspected of being sequestration on standard images. Ultrasonography alone is capable of confirming diagnosis of branchopulmonary sequestration. Results are reported in 8 children, 4 of whom had sequestration.
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One hundred tumours were detected by IV urography and studied by echotomography. In 37 cases, a nephrotomography was performed and in 65 cases a renal arteriogram. The reliability of these three examinations was analysed. Three calcified masses were impossible to analyse by echography and required arteriography from the outset. There were two false negatives related to an error of interpretation and not to any defect in the echography. With regard to the 3 calcified masses, no better information was obtained by nephrotomography. Four necrosed carcinomas were erroneously identified as cysts. Four carcinomas were missed at arteriography. The reliability of echotomography was good apart from in cases of small carcinomas (less than 2 cm) and calcified masses. It proved to be more reliable than nephrotomography and arteriography. By contrast, it was less selective since there were false positive results in 13% of cases.
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Absorption and lymphatic drainage of several lipiodol emulsions injected intraperitoneally have been studied in the rabbit and rat. Good opacification of the lymphatic channels and mediastinal lymph nodes is obtained in several hours with fine emulsions and in several days with coarse emulsions. The tolerance is related to dose, and the peritoneal reaction was moderate with the low doses, similar to that caused by the administration of physiologic saline alone. Computerized tomography in detecting low contrasts attained with small doses could render this method of indirect lymphography possible in man.
The authors studied the validity of Wolf and Dorph's test (increase in size of the kidney with increased diuresis) performed during intravenous urography in hypertensive patients. The technical procedure is described, and the results reported: 1 032 kidneys were measured, of which 84 had been also examined by arteriography. The results are analyzed and compared to those obtained after the standard method of early consecutive films, with the following conclusions: -- the test is not as valid as is suggested by the authors who described it; -- the information supplied by the standard method is more consistent and precise; -- the results of these two series are not completely superimposable; -- that even if Wolf and Dorph's test can sometimes supply useful information, it must not be relied upon completely.
The authors report 9 cases of thoracic lumps investigated by echography in children and adults and operated later. The ulta-sonic study of intra-thoracic lumps is possible thanks to the echographic "windows" which are described; mediastinal and parenchymal lumps can thereby be investigated provided that they have a direct contact point with the chest wall. The echographic examination cannot reveal the histological nature of the lump but it is interesting in that in case of a liquid content it can assert its benignity, all with a technique simple and easy to use especially in children. The reliability of this examination seems good, the echostructure of the lesion being correctly defined in the 9 cases and in the 14 observations in the literature which are summed up.