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Biomedical subjects

P Rohmer

Publications and source records attributed to P Rohmer.

At least 19 recordsLinked to original sources
PubMed1991

Orthotopic liver transplantation for incurable alveolar echinococcosis of the liver: report of 17 cases.

Between 1986 and 1989, orthotopic liver transplantations were performed in our unit for 17 patients with incurable alveolar echinococcosis. Ten patients had hilar involvement (group I), and seven patients had posterior localization (five of them had chronic Budd-Chiari syndrome) (group II). The delay between diagnosis and the orthotopic liver transplantation was more than 48 mo in group Ia (six patients), less than 24 mo in group Ib (four patients) and less than 48 mo in group II. Previous operations were more common in group Ia than in group Ib and II. Five patients have died-four in group I and one in group II. The actuarial survival rate at 15 mo was 75%. Early reoperations were frequent (69%), mainly caused by rebleeding. Bacterial and fungal infections occurred only in group Ia (four cases) and group II (three cases). In eight patients (palliative group), residual foci of infected nonhepatic tissue occurred after surgery. The titer of specific antibodies decreased during the first 3 mo in all the patients but one. In patients with radical liver transplantation, the complete disappearance of specific antibodies occurred within 2 yr in four cases. In the remaining five patients, specific antibodies remained detectable, but no evidence of recurrence has been obtained up to now. In the palliative group, a peak of specific IgM occurred at 3 mo; an increase of specific IgG was observed later. The growth of residual parasitic foci was relatively slow, and all these patients remained asymptomatic with a mean follow-up of 19 mo. We conclude that orthotopic liver transplantation is feasible in incurable alveolar echinococcosis and could be proposed without delay to patients with parasitic Budd-Chiari syndrome or complicated secondary biliary cirrhosis. In the other cases, the best time to perform an orthotopic liver transplantation is more difficult to determine. Nevertheless, in the perspective of an orthotopic liver transplantation, the management of these patients has to change, and repetitive laparotomies for palliative surgical procedures have to be replaced by interventional radiology.

Adult↗
PubMed1990

[Echographic diagnosis of peritoneal metastases in patients with ascites].

A prospective study of 14 malignant ascites examined with high frequency ultrasonic probes enabled he authors to achieve a diagnosis of peritoneal metastases in 78% of cases. Peritoneal metastases appear as areas of peritoneal thickening or scalloping, as nodules, with sometimes a strong bulging, and as intestinal masses. Soft part ultrasound should be employed systematically in the diagnosis and follow up of malignant ascites.

Ascites↗
PubMed1988

Ultrasound of the traumatized spleen: left butterfly sign in lesions masked by echogenic blood clots.

Ultrasonic display of blood on both sides of the splenogastric ligament (left butterfly sign) in the left traumatized patient indicates hemoperitoneum within the lesser sac. Particular attention must be paid then to the splenic parenchyma, where isoechogenic blood clots can mask a hematoma. The association of subtile parenchymal changes and of a left butterfly sign are relevant of frank splenic lesions.

Hematoma↗
PubMed1988

[Ultrasonography and x-ray computed tomography in the diagnosis of intra-abdominal textiloma. Apropos of 12 cases].

Feared by every surgeon, retained surgical sponges (or gossypiboma) are rare iatrogenic entities. Ultrasonography and computed tomography are very valuable, providing an immediate answer in the majority of cases. We report 12 cases of intra-abdominal retained surgical swabs. The ultrasonic pattern was made whether of a large poorly echogenic mass with a hyper-echogenic center and sharply delineated posterior acoustic shadow (7 cases) or of a large acoustic shadow posterior to a solitary highly echogenic area (4 cases). Computed tomography demonstrated whether large peripherally enhanced cystic mass associated with serpiginous or spongiform central area (5 cases) or heterogeneous abscess-like fluid mass.

Abdomen↗
PubMed1986

Ultrasound and CT of peritoneal recesses and ligaments: a pictorial essay.

US and CT permit one to visualize peritoneal recesses and ligaments. Ultrasonic analysis relies mostly on the liquid contrast of peritoneal effusions. CT demonstrates more readily the fatty and vascular contents of ligaments. Thus ultrasound displays essentially the thin part of ligaments, which CT is unable to show due to kinetic blur, whereas CT demonstrates readily the thick fatty parts of those peritoneal elements.

Ascites↗
PubMed1986

[The place of ultrasonics in the diagnosis of traumatic hemoperitoneum].

Classically, the diagnosis of hemoperitoneum is based on clinical symptoms, which are not always relevant. Several complementary procedures can be considered when dealing with polytraumatic patients who may be comatose: scintigraphy, arteriography, CT, sonography and peritoneal lavage. The authors have finally selected sonography and lavage. Since ultrasound is reliable, reproductable and non aggressive, it is being more and more utilized. It readily shows solid-liquid contrast, and is particularly sensitive in displaying fluid in peritoneal recesses; parenchymal lesions are also evaluated. II enables one to explore the abdominal cavity with precision. Lavage is reserved for acute lesion with severe, evolutive hemoperitoneum, requiring immediate surgery. The indications for other imaging modalities are also discussed.

Abdominal Injuries↗
PubMed1986

[Ultrasonics in abdominal emergencies. Results of a series of 179 cases].

The study of a series of 179 emergency ultrasonic examinations showed a sensitivity of 97% and a specificity of 98%. Such results confirm the reliability of real-time sonography in the assessment of the acute abdomen, obstructive intestinal syndromes still requiring mainly conventional procedures. With this exception, the part of ultrasound in the diagnostic and the therapeutic strategies is essential. Associated to plain X-ray films, it enables one to curb down the number of other imaging procedures, such as IVP, angiography, or CT. Emergency ultrasound, particularly in traumatology, requires trained, competent radiologists. Performant machines should be available in admittance and intensive care wards.

Abdomen↗
PubMed1986

[An x-ray computed tomographic study of peritoneal ligaments and various mesos].

The CT analysis of peritoneal ligaments and mesos is possible thanks to the fluid contrast introduced by ascites, but also by identification of their contents: fat and opacified vascular elements. Ascites renders easy the display of the falciform ligament. Other displayed ligaments are the smaller omentum, the gastrosplenic ligament, the splenopancreatic ligament, the phrenolienal and phrenocolonic ligaments, the mesocolon, the mesosigmoid, the mesentery and the broad ligaments. The radioanatomic patterns of those peritoneal elements are depicted.

Ascites↗
PubMed1985

Hepatic alveolar echinococcosis: correlative US and CT study.

A total of 24 cases of hepatic alveolar echinococcosis (HAE) due to Echinococcus multilocularis was assessed by US and CT. The diagnosis was confirmed in all cases by immunologic and histologic study. Both US and CT patterns of HAE showed changes of liver morphology in both contour and size. Abnormal areas of parenchyma were nodular or in fields, irregular, heterogeneous, and basically echogenic. On CT these lesions were hypodense (30 to 40 HU) and did not show enhancement after administration of intravenous contrast medium. Clustered microcalcifications were encountered within the abnormal parenchymal fields in 50% of cases, and necrotized zones occurred in 40% of cases. Dilatation of intrahepatic bile ducts was commonly seen, especially on US; hilar involvement was frequent. Follow-up by both techniques can display increases of primary lesions, occurrence of new foci, and local or regional extensions. Precise evaluation of the lesions arising from correlative use of US and CT permits adequate therapeutic management.

Adult↗
PubMed1979

[Gastric and intestinal appearances by abdominal ultrasound. The sign of brownian motion (author's transl)].

Gastric, as well as intestinal images, are always present on abdominal ultrasonic scans. Since they are difficult to analyse, such images are usually neglected. Morphological and dynamic criterial (as the "brownian movement sign") enable to identify stomach and intestine. It is then possible to avoid the misinterpretation of normal anatomic elements as pathological processes, and, from time to time, to diagnose specific gastrointestinal lesions.

Adult↗