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Biomedical subjects

F Brunelle

Publications and source records attributed to F Brunelle.

At least 181 records · Page 10Linked to original sources
PubMed1983

Portal obstruction in children. I. Clinical investigation and hemorrhage risk.

We examined 108 children with obstruction of the portal vein. Symptoms included splenomegaly and gastrointestinal tract hemorrhage. Obstruction was secondary to portal vein injury in 44 children and was combined with congenital malformations in 17 others. Ultrasonography provided the correct diagnosis in 36 of the 37 children in whom it was performed. Angiography, performed in 101 children, showed that the obstruction extended to the superior mesenteric vein in 14 children and to the entire portal venous system in seven; intrahepatic branches were involved in half the cases. Natural splenorenal shunts were visible in 19 children but were not clearly associated with a lower risk of gastrointestinal tract bleeding; in five of 30 children, cavography displayed abnormalities of the inferior vena cava. Spontaneous gastrointestinal tract hemorrhage occurred in 78 children. Fiberoptic endoscopy showed esophageal varices in 79 of the 81 children studied. The presence of tense varices and congestion of esophageal mucosa clearly augmented the risk of bleeding. These results suggest a simple method of investigation based on ultrasonography for diagnosis and on endoscopy for prognosis. Angiography should be limited to children with a history of gastrointestinal tract bleeding for whom a surgical portosystemic shunt is being considered.

Adolescent↗
PubMed1983

Portal obstruction in children. II. Results of surgical portosystemic shunts.

Seventy-six children with portal vein obstruction underwent surgical portosystemic shunt, for severe gastrointestinal tract bleeding in 64 and for prophylactic purposes in 12. Endoscopy and angiography or both showed shunt patency in 70 children; thrombosis occurred in the remaining six. The mean age at successful shunt surgery was 6 years 10 months. Early postoperative assessment of shunt patency was judged from regression of splenomegaly and thrombocytopenia when splenectomy was not performed; when done, early postoperative ultrasonography correctly indicated the result. Significant regression of endoscopy was most often delayed postoperatively for up to six months. Children with a proved patent shunt did not have any further episodes of gastrointestinal tract bleeding, displayed no clinical signs of encephalopathy, and often exhibited a striking increase in growth velocity. These results strongly support the contention that a portosystemic shunt is the best treatment for portal vein obstruction after the first spontaneous bleeding episode, even in young children.

Adolescent↗
PubMed1981

Ultrasonography and percutaneous cholangiography in children with dilated bile ducts. Report of six cases.

Six children had dilation of intrahepatic and extrahepatic bile ducts. The dilation was associated with or was secondary to lithiasis in two patients, spontaneous bile duct perforation in two others, and an abnormal pancreaticobiliary junction in the last two. All the children were screened by ultrasonography; five were subsequently examined by percutaneous transhepatic cholangiography. Ultrasonography permits rapid detection of bile duct dilation, while percutaneous cholangiography aids in the choice of the surgical procedure by locating the site of obstruction and sometimes disclosing the cause of obstructive jaundice.

Bile Duct Diseases↗
PubMed1981

Congenital hepatic fibrosis in children.

Twenty-seven children with congenital hepatic fibrosis were followed for three months to 12 years. Hepatosplenomegaly, normal liver function tests, and kidney abnormalities were present in most patients, indicating that a correct diagnosis of congenital hepatic fibrosis could be made using simple clinical, biologic, and radiologic criteria. Esophageal endoscopy showed varices in 21 patients. Sixteen children underwent portal-systemic shunt surgery. Follow-up examinations did not show any impairment of liver function or any sign of hepatic encephalopathy. Cholangitis was present in only three children.

Adolescent↗
PubMed1981

Vascular occlusive agents.

The authors have reviewed the experimental literature about the different agents used for endovascular embolization: clots, tissues, duramater, Gelfoam, oxydized cellulose, Ivalon, beads, microspheres, cyanoacrylates, silicone, barium. Each occlusive agent was studied in regard to its physical properties, injection methods, characteristics of obstruction, vascular reaction, and toxicity. The level and quality of obstruction obtained depend on many factors which are discussed.

Animals↗
PubMed1980

[Ultrasound and portal hypertension in children. Demonstration of gastro-oesophageal collaterals. Preliminary report (author's transl)].

The authors studied the value of ultrasonography in demonstrating oesophageal collaterals in portal hypertension in childhood. 22 children with portal hypertension underwent successively an ultrasound examination and an endoscopy looking for submucosal oesophageal varices. Oesophageal collaterals were said to be present when ultrasound showed vascular structures in the gastro-hepatic ligament above the coeliac trunk origin. Among those 22 patient 18 had a satisfactory ultrasound examination. 12 true positive, 3 true negative, 3 false negative ultrasound examinations were obtained. 4 ultrasound studies were inconclusive. The value of ultrasound in the pre and post surgical check-up of portal hypertension in children is emphasized.

Adolescent↗
PubMed1979

[Intestinal obstruction with feces (meconium ileus equivalent) in the course of mucoviscidosis. Radiographic diagnosis (author's transl].

Meconium ileus equivalent is a late intestinal occlusion occurring in patients suffering from mucoviscidosis. Three cases are reported in children aged, respectively, 3 years, 6 years and 10 years. In one of the observations (three year old girl), the intestinal obstruction with feces was first manifestation of a mucoviscidosis that was previously undetected. The radiological signs are identical to those found in cases of neonatal meconium ileus: intestinal obstruction and accumulation of closely spaced matter in a distended ileum (terminal part). As in cases of meconium ileus without complications, treatment consisted of enemas with water-soluble products. The high osmotic pressure of these products made it possible to remove the obstruction.

Child↗