[Echographic aspects of 2 cases of Vater's ampulloma].
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Biomedical subjects
Publications and source records attributed to R Bénacerraf.
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From October 1982 to October 1984, a percutaneous drainage under realtime ultrasound guidance was performed in 53 patients with abdominal abscesses. The location of the abscesses was subphrenic (23), retroperitoneal (16), and intrahepatic (14). A safe access route was found by using ultrasound and fluoroscopy in 53 out of 55 patients (96 p. 100). Percutaneous drainage failed in 8 patients and 3 of these patients died. The causes of death were: cerebral abscess (1), renal failure after surgery for correction of a duodenal fistula (1), and pancreatic abscess (1). The other five patients were cured by surgical drainage. Two complications were observed: one case each of pneumothorax and purulent peritonitis. Forty-five patients were healed by percutaneous drainage without operation. The duration of the catheter drainage was 14 days +/- 13 (m +/- 1 SD). Our results suggest that percutaneous drainage under realtime ultrasound guidance is an efficient and safe way to treat abdominal abscesses.
Two cases of alveolar echinococcosis were observed, the first in a 30 year old man, suffering from a hepatic localization, of the classical icteric and tumoral form, the second in a 26 year old patient, with an exclusively splenic localization, a very exceptional possibility. In both cases, coeliac arteriography showed vascular lesions which led one to suspect the diagnosis. To our knowledge, this is the first case of alveolar echinococcosis explored by arteriography. Furthermore, in the first patient, retrograde catheterization of the biliary tract was carried out, which showed very marked changes of the biliary tract. Inspite of the amount of information provided by the radiological investigations, the diagnosis was not made until the surgical intervention.
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