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Biomedical subjects

R F Dondelinger

Publications and source records attributed to R F Dondelinger.

At least 73 records · Page 4Linked to original sources
PubMed1995

A short history of non-vascular interventional radiology.

Interventional Radiology can be defined as minimally invasive closed percutaneous procedures for diagnosis or treatment and guided by imaging techniques. Parallel to the development of Interventional vascularRadiology, non vascular techniques have evolved. Margulis coined the term "Interventional Radiology" describing percutaneous extraction of residual gallstones. Fluoroscopy guided biopsy of the lung and mediastinum were described in the thorax by Nordenstrom. Percutaneous approach to the bile ducts was clinically applied by Wiechel, Lunderquist and Wallace. T-Tube extraction of residual gallstones was popularized by Burhenne. Cross sectional imaging, Ultrasonography and Computed Tomography offered the indispensable anatomical precision allowing a percutaneous approach to the deeply located structures in an axial plane. Haaga and Alfidi described percutaneous tissue sampling and drainage procedures guided by CT. Holm developed Ultrasound guided drainage and Otto initiated the perforated transducer. Percutaneous drainage of fluid collections rapidly became a standard. Plastic stents were inserted percutaneously in the bile ducts by Pereiras. Percutaneous neurolysis of the coeliac plexus was described by Hegedus Direct injection of ethanol and laser ablation of liver tumors, diskectomy and tubal recanalization are other more recently developed procedures.

Bile↗
PubMed1994

A single focus of probable multiple sclerosis in the cervical spinal cord mimicking a tumour.

A case of probable multiple sclerosis (MS) in the cervical cord without brain involvement, mimicking a tumour is reported. The patient had a progressive left Brown-Séquard syndrome. The diagnosis was suggested by MRI. In spite of intensive corticotherapy, the neurological status worsened, in parallel with the radiological findings. Biopsy excluded an intramedullary tumour and supported the diagnosis of MS.

Adult↗
PubMed1994

Percutaneous coil embolization of iatrogenic femoral arteriovenous fistula or pseudo-aneurysm.

Five male patients aged 43-67 years (mean, 60) with four iatrogenic femoral arteriovenous fistula and two pseudo-aneurysms (1 and 4 cm in diameter) were treated by percutaneous embolization, with coils. One coil migrated during placement to the pulmonary artery without clinical symptoms. All lesions remained obliterated after a mean follow-up of 10 months on Duplex-Doppler control. External manual compression under color-coded-Doppler was tried in three patients and failed.

Adult↗
PubMed1994

[Pulmonary epithelioid hemangioendothelioma with hepatic secondary location].

Hepatic metastases secondary to a primary pulmonary epithelioid hemangioendothelioma are demonstrated in a patient after a follow-up of 11 years. Three years after diagnosis of metastases, the patient is in good general condition. MRI of hepatic epithelioid hemangioendothelioma is not specific and histologic confirmation is mandatory.

Adult↗
PubMed1993

Small bowel enema and diagnosis of chronic nonischemic disturbance of superior mesenteric venous blood flow.

Chronic nonischemic disturbance of mesenteric venous blood flow is reported in 11 patients with a mean age of 19 years. This entity, rarely discussed in the literature, is different from acute thrombosis and chronic thrombotic forms with portal hypertension or hypercoagulopathy. In eight patients this syndrome was secondary to organic lesions of different origin: mesenteric vein squeezed by fibrous bands or an abnormal jejunal artery (four cases), lymphoma involving the distal superior mesenteric veins (three cases), hemangioma causing microthrombi (one case). In three patients no etiology or predisposing factor was found. All patients presented with rectal hemorrhage. Small bowel enema showed a constant pattern in 11 patients: small nodules, modified by compression or peristalsis, involving the mesenteric border of the jejunoileal segment, and associated with thick, straight but regular folds. Mesenteric varices were suspected and led to angiographic studies which were normal in three cases, confirmed varices in eight cases, and thrombosis in four cases. Laparotomy was normal in three cases and established the etiological diagnosis in eight cases. Varices were shown in six cases. Arteriography and laparotomy were unable to reach a complete diagnosis.

Adolescent↗
PubMed1993

[Severe complications after cholecystectomy by celioscopy: lessons from yesterday and today].

The case of a series of grave complications after a laparoscopic cholecystectomy is reported: a common bile duct section diagnosed rather late, hemoperitoneum, inappropriate common bile duct reconstruction and late anastomic leakage, stenosis of an hepatico-jejunal anastomosis, haemorrhage through the external biliary drainage and iterating sepsis. The final outcome was good. The stenotic hepatico-jejunal anastomosis was dilated by a Gianturco self-expanding prosthesis percutaneously placed. As an evidence, this alternative treatment is only exceptional, the treatment of choice for postsurgical benign strictures being surgical repair.

Anastomosis, Surgical↗
PubMed1993

Duplex ultrasonographic evaluation of liver transplants.

Two hundred and twenty-two duplex ultrasonographic examinations were performed on 36 liver transplants in 30 patients over a period of 5 years and 9 months. Positive sonographic findings were correlated with 13 angiographic examinations. Arterial complications included 4 thromboses, 5 stenoses, and one mycotic aneurysm. A false-negative result was obtained in 2 cases of stenosis and a false-positive result in one case of thrombosis. One portal vein thrombosis, 2 stenoses, and 2 cases of portal hypertension were diagnosed correctly. Sensitivity was 87%, specificity 95%, and accuracy 93%. Duplex Doppler was least effective in the diagnosis of hepatic artery stenosis. Five cases showed biliary complications of ischemic origin. Angiography is indicated when duplex Doppler is positive or doubtful, but also when the clinical condition is unclear.

Adult↗
PubMed1991

Small intestinal obstruction caused by extramedullary hemopoiesis and revealing myeloproliferative syndrome.

A 60-year-old woman was admitted with mild intestinal obstruction. Enteroclysis showed segmental narrowing with mucosal fold thickening of the proximal jejunum. Computed tomography in addition demonstrated enlarged mesenteric lymph nodes in the proximity of the diseased intestinal loop. Histological examination of the resected intestinal segment showed extramedullary hemopoiesis. Bone marrow examination confirmed myeloproliferative syndrome.

Barium Sulfate↗
PubMed1991

Percutaneous local arterial thrombolytic infusion. Therapeutic effects and complications.

All complications occurring in 55 local thrombolytic infusions performed for (sub)acute limb ischemia using streptokinase (SK) in 22 procedures and urokinase (UK) in 33 procedures were recorded. Success was achieved in 74.5% of the procedures. Major complications occurred in 31.8% of the procedures using SK, and in 12.1% of the procedures using UK (p = 0.07). Hemorrhage was the most common major complication and occurred in 27.2% of SK procedures and in 9.0% of UK procedures, a difference which was not significant. Overall, 30 day mortality was 16.3% and procedure-related death was 1.8%. Moderate complications necessitating only the adjustment of drug regimen and minor complications without consequence were observed in 45.5% and 45.5%, respectively, of the SK procedures, and in 57.6% and 66.7% of the UK procedures.

Adult↗
PubMed1990

[Treatment of massive arterial thrombosis caused by thrombocytopenia induced by heparin with local thrombolysis].

The authors report the case of a patient treated by subcutaneous injection of calcium heparin after deep vein thrombosis with floating thrombus and pulmonary embolism. She was readmitted to hospital after 16 days' treatment because of a massive aorto-iliac thrombosis due to heparin-induced thrombocytopenia (platelet count = 29.000). This thrombosis was treated by local injection of Urokinase (total dose = 7.425.000 U) over 93 hours without any major complications. The aorto-iliac circulation was completely restored to normal after treatment. Thrombotic complications secondary to immuno-allergic heparin-induced thrombocytopenia are relatively common because of the widespread use of heparin. From the therapeutic point of view, it is imperative to stop the heparin, which makes surgery very difficult, and the platelet-fibrin composition of these thrombi suggests that local thrombolysis with Urokinase is the treatment of choice in this syndrome.

Aorta, Abdominal↗
PubMed1989

Gianturco expandable metallic biliary stents: results of a European clinical trial.

Eleven patients with benign strictures (after choledochojejunostomy, n = 10; chronic pancreatitis, n = 1) and 16 with malignant biliary strictures (cancer of the pancreas, n = 7; cholangiocarcinoma, n = 5) were treated with a self-expanding metallic biliary stent. The patients with benign disease had failed treatment with surgical reconstruction and transhepatic balloon dilation. All patients had immediate relief of jaundice and cholangitis. In a follow-up period of 6-21 months, nine of the 11 patients with benign disease had no difficulties with infection, pruritus, or recurrent jaundice. In patients with malignant strictures, the stent produced relief of biliary obstruction unless recurrent tumor invaded the bile ducts. With careful patient selection, this stent appears to be useful in the management of biliary obstruction, particularly in benign disease.

Adult↗