A suprasternal approach to the mediastinum using real-time ultrasonography. Echoanatomical correlations.

This work was undertaken in order to define the potential capabilities of real-time echography for the exploration of the mediastinum by a suprasternal approach. We present the results of a comparative study between anatomical frontal oblique sections of the mediastinum and echographic slices performed along the same planes from the suprasternal fossa. From these data, it seems possible to enlarge the applications of echography in the study of mediastinal pathology.

[Echographic study of the normal adrenal gland during development and in the adult]. / Etude échographique de la glande surrénale normale au cours du développement et chez l'adulte.

An echographic study of the normal adrenal glands is realized on normal out patients, and anatomic slices. A comparison is made between echographic and anatomic images. This study demonstrates the image of the normal adrenal gland in the fetus, newborn and adult, and reveals a different echo pattern in the cortex (sonolucent) and the medulla (echogenic).

[Ultrasonographic guidance of percutaneous biopsies and punctures]. / Guidage échoscopique des ponctions et biopsies transcutanées.

Real time ultrasonography is routinely used for guidance of percutaneous punctures towards small targets, with three goals: 1. Aspiration biopsies for analysis of an abnormality detected with ultrasonography. 2. Injection of contrast media inside normal structures (urinary, biliary or pancreatic tract) or abnormal collection (cysts, pseudocysts). 3. Treatment by percutaneous sclerosis, aspiration, decompression, drainage.

[Percutaneous puncture under sectorial real time ultrasonography control]. / Technique de ponction percutanée guidée par échographe temps réel sectoriel.

A technique for percutaneous puncture is described which employs sectorial scanning real time ultrasonography without a mechanical system for needle control. The method has given satisfactory results in 200 punctures, including one case in which a liver metastasis 13 mm in diameter was detected and another case with a wirsung's duct of 4 mm diameter.

[Suprapubic prostatic ultrasonography (author's transl)]. / Examen de la prostate par échographie sus-pubienne.

Suprapubic ultrasonography is now routinely used for prostatic examination as it is simple, non-invasive and accurate. Differential diagnosis between benign hypertrophy and cancer is often possible. Evaluation of the size of the prostate is accurate and is a satisfactory means of monitoring the effect of treatment for prostatic cancer.

[Suprarenal cysts. Diagnostic value of percutaneous puncture guided by echoscopy (author's transl)]. / Kyste surrénalien. Apport diagnostique de la ponction percutanée guidée par échoscopie.

Percutaneous needle aspiration was carried out in one case of suprarenal cysts which had already been evaluated by pyelography, echography and angiography. The characteristics of the aspirated liquid pointed towards a benign lesion, and enabled conservative treatment to be initiated. More generally, diagnosis of suprarenal tumors benefits from the direct approach already applied to other abdominal tumors.

[Arteriovenous fistula of the spleen revealed by ascites and profuse diarrhea. A case report including ultrasonography and arteriography findings (author's transl)]. / Ascite et diarrhées profuses révélatrices d'une fistule artério-veineuse splénique. Evaluation échographique et artériographique.

Abdominal pain, ascites and diarrhea revealed acute portal hypertension in a young woman. Ultrasonography and angiography demonstrated the causative congenital arterio-venous fistula of the splenic vessels. Surgery was successfully performed.

[Pseudocysts of the pancreas presenting in the kidney region. A report on two cases (author's transl)]. / Pseudo-kystes du pancréas à expression rénale. A propos de deux observations.

Two cases of pseudocysts of the pancreas presenting in the kidney region are reported. The authors stress the value of renal and coeliomesenteric arteriography for establishing the etiological diagnosis of atypical cystic formations of the kidney.

[Diagnosis of a non-functioning kidney pelvis in adults: a report on 12 cases (author's transl)]. / Diagnositc des pyélons non fonctionnels chez l'adulte. A propos de 12 cas.

Two types of non-functioning supernumerary kidney pelvis are defined by analyzing 12 cases discovered in adult life. Those of congenital origin from glomerular aplasia, sometimes associated with a ureterocele or an ectopic anastomosis, and those due to an acquired lesion such as lithiasis, vesico-ureteral reflux, or secondary infection of a pocket of fluid. Radiological diagnosis is made by IVU with descending cystography and films taken during micturition. Cystoscopy and possibly retrograde ureteropyelography are essential in order to confirm the diagnosis.

[Gastroduodenal complications after the ingestion of hydrochloric acid. One case (author's transl)]. / Complications gastroduodénales après ingestion d'acide chlorhydrique. A propos d'une observation.

The ingestion of a caustic acid resulted in retractile fibrosis of 2/3 of the stomach with a secondary duodenal fistula. The antro-pyloro-duodenal circuit was re-established at around the 3rd after ingestion. However, the duodenal fistula caused the formation of encysted pelvic abscesses which were difficult to drain and satisfactorily treat. The clinical course stretched over a period of 4 years.