Biomedical subjects
Publications and source records attributed to J Chermet.
Pseudo-membranous colitis may develop after treatment with antibiotics, and in particular lincomycin a, d clindamycin. A "thumbprint" appearance of lacunae 2 to 4 mm in diameter, in substraction in relation to the wall of the colon, diffuse involvement of the colon and the regression of these signs when antibiotics are stopped are the typical radiological signs of this disorder.
Duplicating x-ray films is a matter of interest to all physicians, even if they are not radiologists. The impossibility of a direct reading is a major drawback of reproduction in the form of slides. By contrast, a transparency is an irreplaceable teaching tool. Contact printing of slides on counterpart film is a process within the reach of all departments of radiology. In one single step, this process gives a plate of 100 transparencies on counterpart film costing about 2.20 dollars.
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On the basis of 72 radio-surgical cases of abdominal aortic aneurism, the authors stress the value of atypical angiographic findings, which are ten in number. The presence of clot within the aneurism itself may explain a disparity between radiological and surgical findings. Failure to recognize these atypical signs is very serious, when the diagnosis of aneurism is not suspected clinically. Antero-posterior and, above all, lateral abdominal aortography is essential in the angiographic study of aneurisms of the abdominal aorta. Careful search for these 10 atypical signs should make it possible to avoid missing latent aneurisms. Lateral abdominal aortography is essential in order to determine the state of the abdominal collaterals of the aorta and, in particular, the superior mesenteric artery.
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The authors report 8 cases of lympho-reticulosarcoma of the colon and emphasize the rareness of this tumour (10 percent of cases) compared with other localisations in the stomach and small intestine. Whether primary or secondary, lymphosarcoma of the colon has various radiological appearances, depending on the mode of development of the sarcoma in the wall of the colon. Mainly sub-mucosal, it may remain localised or extend to the whole of the colon, predominating in the ileo-coecal and recto-sigmoid regions. Localised tumour forms present either in the form of large polycyclic lacunae, sometimes invaginated or as vast ulcerations with irregular nodular margin, or as due to parietal infiltration and exoluminal development of the tumour mass and neighbouring adenopathy. It is sometimes confused with carcinoma of the colon, e.g. vegetating carcinoma, colloid carcinoma, or peritoneal metastases, or with a regional abscess, e.g. appendix abscess or diverticulosis. The correct diagnosis is made on operation. The extensive colonic forms rarely take on the appearance of lymphoid pseudopolyposis, more often that of a very unusual nodular form formed of hazy lenticular lacunae. It may be confused with nodular colitis, it differs from this, however, by the absence of ulceration, changes in caliber and the persistance of normal haustration, a reticulated appearance of the mucosal outline during evacuation of the barium. In all cases, the discovery of a colonic lympho-reticulosarcoma implies complete digestive radiological investigation in order to seek gastric, duodenal or intestinal localisations, together with a search for other extra-digestive localisations. In fact, the great diffusion of the lesions modifies the prognosis and the therapeutic attitude. These lymphosarcomas and reticulosarcomas of the colon have a similar pathological and radiological appearance but differ by their sensitivity to treatment with cobalt, as reticulosarcomas are more resistant.
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On the basis of 3,000 selective arteriograms of the coeliac trunk, the authors described the radiological appearance of anastomoses existing between the hepatic arteries. The anatomical study of COUINAUD had shown their existence. The increasingly frequent use of hepatic arteriography makes the demonstration easier. Such anastomoses exist under normal conditions but are more obvious, since they are increased in size, in various pathological states, in particular when there is obstruction of a hepatic artery. The anastomoses are of two types: of small calibre and usually situated in the porta hepatis or in the upper part of the hepatic pedicle; of wide calibre, a true embryonic rest, providing a communication between branches of the hepatic arteries. Such anastomoses may function in both directions. They are of great value under pathological conditions, avoiding hepatic necrosis. They are particularly common in complications following surgery on the common or other bile ducts.
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Reactional hyperaemia is a technique for functional study of the peripheral arterial circulation which may be applied to arteriography. It represents the maximum point on the scale of modifiers of function which may be used in peripheral arteriography. It opens the way to interesting comparison between peripheral arteriography and the various functional studies which may be employed in peripheral vascular pathology.
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The authors report 15 cases including 9 controlled by autopsy, and discuss the usual and unusual angiographic appearances in this disease. These cases strictly fulfilled the criteria necessary for diagnosis. The two angiographic forms seemed to correspond to different therapeutic indications. Takayasu's disease remains a disease of young women and the angiographic diagnosis can only be made during the obstructive phase.
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