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W Rohrschneider

Publications and source records attributed to W Rohrschneider.

6 recordsLinked to original sources

The post-reduction donut sign.

A donut-shaped intestinal structure in the lower right abdomen, observed during abdominal ultrasound investigation following nonoperative intussusception reduction, may create a diagnostic problem concerning differentiation from a residual or recurrent intussusception or underlying small bowel disease. In 30 cases of ileocolic intussusception an abdominal ultrasound examination was performed after reduction, the success of which was proven by radiological and clinical criteria. More than half of the examinations showed an aperistaltic "donut" in the ileocecal region which was similar to the target sign commonly seen in intussusception. Differentiation was possible according to the following two criteria: first, the diameter of the donut was smaller than that of the original target sign seen in these patients. Second, the donut consisted of a broad hypoechoic rim and an echogenic center, whereas the target was normally composed of multiple concentric rings. One third of the patients showed localized thickening of the walls of the distal ileal loops which did not cause diagnostic problems. All of the suspicious intestinal structures disappeared within the first 5 days following reduction. It is our opinion that the post-reduction donut correlates with significant edema of the ileocecal valve and does not represent a mechanical lead point or persisting residual intussusception.

Female

[The initial experiences with a new method for treating invagination: sonography-guided hydrostatic reduction].

During the last four months we have been treating all 15 sonographically diagnosed intussusceptions by a new method; this is based on the introduction of a saline enema under sonographic control. In 13 cases the method was successful according to imaging and clinical criteria. In two patients conservative reduction was impossible: in one patient partial resection of the ileum was necessary and in the other there was a recurrence which was reduced at operation. There were no complications. The advantages of the method are reduced radiation exposure, complete evaluation of the course of the procedure with definite criteria for success, the ability to recognise an ileo-ileal invagination and to determine the head of the intussusceptum. We can see no disadvantages compared with conventional methods. We regard this method as optimal in future for the treatment of infantile intussusceptions.

Child, Preschool

[Ureteropelvic stenosis in infancy. The value of diuresis sonography compared with diuresis excretory urography].

Examinations under conditions of diuresis produced by drugs can be useful to differentiate pyelo-ureteric obstruction from a dilated collecting system with normal flow. 22 infants with 42 kidneys showing moderate dilatation of one of both renal collecting systems were examined by sonography and excretory urography under conditions of diuresis and the results were compared. Depending on the radiological appearances and contrast clearance rates, four diagnostic groups could be identified; these also differed significantly on the sonographic examinations. In general, there was good agreement between the two methods. Carefully performed, diuresis sonography will clearly distinguish between urodynamically significant obstruction from a wide but non-obstructive collecting system. The number of radiographic examinations can therefore be reduced in these patients.

Diagnosis, Differential