Soft cervical disc herniation. CT-surgery correlations.
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Biomedical subjects
Publications and source records attributed to J Tongio.
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Cockett's syndrome is due to compression of the left common iliac vein by the left iliac artery. Anatomical factors and venous anomalies contribute to the venous obstruction. Clinical symptoms only develop in cases with marked compression; they consist of functional disorders predominant in the left lower limb and, frequently, recurrent oedema. The compression may be revealed by complications such as deep thrombosis of the iliac vein or veins of the calf, or pulmonary embolism. The diagnosis is made by phlebo-ilio-cavography.
Angiography of renal tumors confirms the suspected diagnosis and permits an assessment of regional and metastatic spread during the same procedure, thus providing more information as to operability. Furthermore, preoperative tumor embolisation can be done if applicable -- a technique routinely done by us in cases of large tumors.
Severe hematuria after pyelonephrotomy was controlled by the selective injection of noradrenaline into the renal artery. The indications for this conservative therapeutic technique are defined as well as its place in relation to hemostatic surgical procedures.
The authors report two cases of renal pneumatisation immediately following renal artery embolisation performed for carcinoma of the kidney. The particularly painful and inflammatory (high fever, leucocytosis, increased sedimentation rate) led to abdominal X-rays which revealed signs of gas in the kidney. In the first case this consisted of rounded clear areas distributed in a linear fashion and indicative of intravascular pneumatisation. In case n degrees 2, intravascular pneumatisation was accompanied by gas in the calyces. In the absence of suppuration and of proven infectious cause, the authors failed to find any explanation for the presence of gas bubbles in the vessels and calyces of the embolised kidney.
A 50 years old man with clinical manifestations of intestinal ischemia associated with malabsorption. On abdominal angiography an obstruction of the 3rd jejunal artery is seen. Barium meal revealed a diffuse jejunopathy with disappearance of mucosal folds and intestinal biopsy showed a complete loss of villi.
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The authors report 4 cases angiomyolipomas in which the preoperative diagnosis was that of a malignant tumour. They stress the difficulties of arteriographic and even histological diagnosis of these rare tumours of the renal parenchyma.
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In this paper are described two new examples of a peculiar semiological association of which the authors have already reported a case, and in which occured simultaneously a phreno-coeliac disease and merycism since childhood. Strong epigastric pains accompained the merycism. In these two cases, the compression of the coeliac trunk by the median arcuate ligament of the diaphragm was important; in one case existed besides a compressive stenosis of the superior mesenteric artery. After the surgical liberation of the coeliac artery and the peri-coeliac neurectomy in one case, all symptoms relieved. This good result persists after twelve months. Because of the rarity of the phreno-coeliac disease and of this type of merycism, the authors think that this association is not accidental, but the result of a new nosological association.
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We feel that arteriography occupies at the present time an indispensable and irreplaceable role in the pre-therapeutic assessment of a soft tissue tumour of the extremities. It obviously cannot provide a definite diagnosis in all cases with regard to the benign or malignant nature of the lesion. However careful analysis of the various features of the images obtained, leading to a radiological classification of the tumour into one of three groups (LEVIN, WATSON and BALTAXE), makes possible, in groups I and III, to predict the nature with a high probability of accuracy. Only in type II (35% of our cases) is it impossible to make such a deduction. The value of arteriography is not limited to diagnosis. It also provides information on the extent and arterial supply of the tumour which are essential to the surgeon and which cannot be supplied by any other investigation.
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