[Hemodynamic disorders related to the injection of contrast media in aortic vascular surgery].
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Biomedical subjects
Publications and source records attributed to G Janvier.
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A new paraprosthetic enteric fistula case between the small bowel and the body of a Dacron aortobifemoral prosthesis is presented. That complication happened five years after the initial reconstruction and the fistula does not interest an anastomotic site. A process is rare (22 published cases); if symptomatology is often less important than complete fistulas, surgical therapy must be aggressive to be effective.
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Purulent pleural effusions due to anaerobic organisms secondary to infections of the pulmonary parenchyma are complications which often occur following the inhalation of organisms from the buccal cavity. The most commonly found organisms belong to the endogenous anaerobic flora of Veillon. Rapid encystment of the pleural collection is suggestive of this diagnosis. Treatment consists of drainage of the cavity associated with specific antibiotics.
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A sinus arrest occured during a surgical intervention in a patient suffering from a sinus nodal dysfunction. The Fentanyl acetate used as an analgésic, seems to have played an important role in the genesis of the accident, depressing sinusal and junctional automatisms. Though unusual, this complication leads to a further investigation in preoperative period for a possible sinus nodal dysfunction in order to anticipate an extreme preoperative bradycardia (sino atrial block) treated with intravenous administration of isoprenaline. Intraveinous atropine test is a simple preoperative technique of research in front all unexplained sinus bradycardia.
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To determine sensitivity to catecholamines after lumbar sympathectomy the authors first tested it in dogs : there was an increase in reactions to catecholamine beyond doubt after bilateral lumbar sympathectomy. In patients with arteritis they recorded, on a segment of the lower limb, a rheographic tracing with simultaneous modifications of the arterial blood pressure and electrocardiogram. These were studied after injection of adrenalin or noradrenalin in a dose of 5 to 7.5 mug (physiologic or stress level). Each of these tests were performed before and after lumbar sympathectomy.
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