O Durieux | PubMed Health

PubMed2005

[Normal pancreas aspects. Variations and malformations].

Major advances have occurred with regards to imaging of the pancreas. In spite of harmonic imaging, US remains limited. Multi-detector CT allows excellent evaluation of the pancreatic parenchyma with multiplanar ductal and vascular reformations. MRI provides excellent evaluation of the pancreatic parenchyma using fat suppressed T1W images and excellent evaluation of the biliary tract and pancreatic duct using T2W images. Senile pancreas is characterized by atrophy and ductal dilatation, sometimes microcystic. Fatty infiltration of the pancreas could be focal or diffuse. Pancreas divisum is characterized by the absence of fusion of the pancreatic ducts with several anatomic variants. Annular pancreas results from malrotation of the pancreatic buds. MRI is the best technique to diagnose these malformations.

Adipose Tissue↗

PubMed2004

[Efficacy of angioplasty of native coarctations of the aorta of the big infant and of the adult with systematic endoprosthesis implantation].

The angioplasty of native coarcatations of the aorta remains a controversial treatment due to recurrences and the potential risk of aneurysm or of descending aorta dissection during catheterization. The interest of a systematic implantation of an endoprothesis is poorly documented. We report our experience in a small series of 3 patients aged from 7, 28 to 52 years at the moment of the angioplasty of their native aortic coarctation. In all the three cases it corresponded to a "membranous" type, localized a the level of the isthmus without hypoplasia of the aortic arch. All presented a refractory hypertension. One patient presented an intermittent claudication related to a low perfusion of lower limbs. The angioplasty was performed with BIB balloon, associated at the same time with the implantation of a Palmaz P308 stent in two cases and Genesis PG2910P in the last patient. The efficacy was immediate in all the 3 cases with stopping antihypertensive drugs at the very day of the procedure. The immediate results were complicated by a bilateral hematoma of the scarpa in a context of excessive anticoagulation in one patient requiring blood tranfusion. After a follow-up of one, 12 and 21 months, all the 3 patients are asymptomatic without any significant residual hypertension. The control scan of the infant confirmed the absence of re-coarctation. In conclusion, the angioplasty followed by systematic implantation of an endoprosthesis is a safe and effective technique for treating simple forms of native coarctations of the aortic isthmus. It can be proposed as a first line treatment for big infants and adults affected by localized types.

Adult↗