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Biomedical subjects

R F Dondelinger

Publications and source records attributed to R F Dondelinger.

102 records · Page 6Linked to original sources
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Delayed esophageal hemorrhage caused by a metal stent: treatment with embolization.

We report a case of life-threatening esophageal hemorrhage after metal stent implantation successfully treated by arterial embolization. An 85-year-old woman was admitted in shock secondary to massive hematemesis and melena. Recent medical history revealed esophageal cancer treated 8 weeks previously by endoesophageal radiotherapy (40 Gy) and endoscopic placement of a covered Wall-stent prosthesis. Selective arteriography of the fifth posterior right intercostal artery showed massive contrast extravasation in the esophagus. Embolization was performed with 150-250-micron polyvinyl alcohol particles. Follow-up at 5 months was uneventful. Arteriography and embolization are advised when severe hemorrhage occurs after esophageal implantation of metal stents.

Aged↗
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Radiologic damage control: evaluation of a combined CT and angiography suite with a pivoting table.

PURPOSE: To evaluate retrospectively the integrated diagnostic and therapeutic management of severely polytraumatized patients using a combined computed tomography (CT) and angiography suite with a single pivoting table. METHODS: Eleven patients, aged 16-74 years (median 30 years), were managed with spiral CT and angiography without patient transfer. Four patients were unstable, seven had received blood transfusions (2-18 units) and six were intubated. In 10 patients in whom active bleeding was demonstrated (splenic 5, hepatic 2, renal 2, left inferior epigastric artery 1), hemostatic embolization was obtained. RESULTS: Total procedure time did not exceed 80 min. Immediate hemostasis was achieved in all patients. Recurrent bleeding from the liver required additional embolization in one patient. Median length of stay in the intensive care unit was 4 days and median hospital stay was 27 days. All patients survived without significant sequelae. CONCLUSION: The use of a combined CT-angiography suite enables rapid diagnostic investigation and hemostatic embolization in actively bleeding trauma patients.

Adolescent↗
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Percutaneous vascular foreign body retrieval: experience of an 11-year period.

Over an 11-year period, percutaneous retrieval of intravascular foreign bodies was performed in 12 patients, using urological forceps and retrieval baskets. No clinically significant complication occurred, success rate was 100%. Review of 176 cases from the literature showed a success rate of 90%.

Adolescent↗
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Tension mediastinal emphysema: emergency percutaneous drainage with CT guidance.

Four patients aged 8 to 54 years, under mechanical ventilation, presented with sudden tension mediastinal emphysema and exhibited typical clinical symptoms of compromised venous return. Diagnosis of tension mediastinal emphysema was confirmed by CT. A percutaneous catheter with a diameter varying from F12 to F20 was inserted in the anterior mediastinal compartment with CT control and connected to a waterseal aspiration. Emergency treatment was efficient in all patients. Percutaneous aspiration was continued for 3 to 20 days.

Adult↗
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Comparison of spin echo, gradient echo and fat saturation magnetic resonance imaging sequences for imaging the canine elbow.

Two comparison studies were performed. In the first conventional spin-echo (T1- and T2-weighted) sequences and a three-dimensional (3-D Fourier transform [3DFT]) echo gradient fast-imaging sequence were compared for imaging the canine normal elbow joint. In all three sequences, there was an isointense signal of the articular cartilage and a hyposignal of the subchondral bone, as compared with the muscles. The medial coronoid process of the ulna was clearly seen on the dorsal plane images, it appeared with a homogenous low-intensity signal. Its articulation with the radius was clearly outlined. In a second study, the 3DFT echo gradient fast-imaging sequence was compared to a fat saturation sequence on normal shoulder and elbow joints. Elbows were imaged with and without injection of saline, in an attempt to show the opposing cartilaginous articular surfaces. This distinction was possible in the shoulder joint but not in the elbow because of insufficient spatial resolution. On the three MRI sequences compared, gradient echo fast imaging with steady-state precession (GE FISP) sequence was found to be the most suitable for imaging the canine elbow joint.

Animals↗
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Probable trigeminal nerve schwannoma in a dog.

A 7-year-old male Husky dog developed atrophy of the right masseter muscle and pruritus of the right side of the face. A myogenic origin was excluded using muscular biopsy. Electrophysiologically, there was involvement of the motor and sensory fibers of the trigeminal nerve, suggesting a lesion located between the brainstem and the trigeminal ganglion. On MRI examination, a nodular mass was detected in the right caudal fossa. This mass was characterized by intense enhancement after injection of contrast medium. Because of the progressive clinical signs, electrophysiology, and MRI results, a presumptive diagnosis of a trigeminal nerve schwannoma was made. The animal's condition improved slightly with corticosteroids. The dog underwent euthanasia 3 months after initial presentation. Necropsy was not performed.

Animals↗
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Congenital bronchial abnormalities revisited.

Bronchial anatomy is adequately demonstrated with the appropriate spiral computed tomographic technique on cross-sectional images, multiplanar reconstruction images, and three-dimensional reconstruction images. Contrary to the numerous variations of lobar or segmental bronchial subdivisions, abnormal bronchi originating from the trachea or main bronchi are rare. Major bronchial abnormalities include accessory cardiac bronchus (ACB) and "tracheal" bronchus. An ACB is a supernumerary bronchus from the inner wall of the right main bronchus or intermediate bronchus that progresses toward the pericardium. Fourteen ACBs were found in 17,500 consecutive patients (frequency, 0.08%). The term tracheal bronchus encompasses a variety of bronchial anomalies originating from the trachea or main bronchus and directed to the upper lobe. In a series of 35 tracheal bronchi, only eight originated from the trachea, three originated from the carina, and 24 originated from the bronchi. Displaced tracheal bronchi (27 of 35) are more frequent than supernumerary tracheal bronchi (eight of 35). Minor bronchial abnormalities include variants of tracheal bronchus, displaced segmental bronchi, and bronchial agenesis. The main embryogenic hypotheses for congenital bronchial abnormalities are the reduction, migration, and selection theories. Knowledge and understanding of congenital bronchial abnormalities may have important implications for diagnosis, bronchoscopy, surgery, brachytherapy, and intubation.

Adult↗
PubMedDate not supplied

Percutaneous phenol block of the upper thoracic sympathetic chain with computed tomography guidance. A new technique.

Twenty-one percutaneous neurolyses of the upper thoracic sympathetic chain were performed in 12 patients with CT guidance by a single injection of 1 to 3 ml of phenol at the level of Th3. Results were assessed after a follow-up period varying from 4 to 33 months. Three patients with hyperhidrosis had immediate and complete disappearance of symptoms, but only one patient remained dry. In 7/14 procedures done for Raynaud's disease symptoms disappeared or diminished. These long term results are competitive with surgery. Three transitory Horner syndromes and one pneumothorax occurred.

Adult↗