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C A Rohrmann

Publications and source records attributed to C A Rohrmann.

48 records · Page 3Linked to original sources

The normal endoscopic pancreatogram.

Pancreatograms of 102 patients with proved normal pancreatic status were reviewed to establish normal standards of pancreatic ductal morphology, and precise details of ductal course, position, length, caliber, and variant anatomy were analyzed. The ampulla was found at the level of the second lumbar vertebra in 75% of cases, while the pancreatic duct crossed the spine at L1 in most cases. Mean ductal diameters were 3.1, 2.0 and 0.9 mm in the head, body, and tail of the pancreas, respectively.

Adolescent↗

The significance of pancreatic ductal obstruction in differential diagnosis of the abnormal endoscopic retrograde pancreatogram.

Apparent obstruction of the main pancreatic duct was seen on the endoscopic retrograde pancreatogram in 50 patients. The final diagnosis was pseudocyst in 15, neoplasm in 15, chronic pancreatitis in 8, acute recurrent pancreatitis in 3, and abscess in 2. Seven patients were normal. This series emphasizes the broad differential approach necessary when confronted with ductal obstruction. Diagnosis is facilitated by accurate evaluation of the ductal and extraductal characteristics, especially the ductal detail at the point of termination.

Acute Disease↗

The radiologic manifestations of idiopathic intestinal pseudoobstruction.

Six patients with idopathic intestinal pseudoobstruction underwent extensive radiographic evaluation of the gastrointestinal tract. Propulsive motor activity was consistently absent. All had smooth muscle dysfunction of the esophagus, small bowel, and colon, and two had abnormal gastric emptying. Two forms of the syndrome were observed, characterized by either hyper- or hypoactive smooth muscle. In the hyperactive form chaotic, spontaneous contractions of the esophagus and small intestine occurred and extensive diverticular disease of the colon was present. In the hypoactive form the esophagus was atonic and there was marked widening and hypomotility of the small intestine and colon. The presence of two forms of smooth muscle dysfunction suggests that the syndrome has a heterogeneous pathology and pathophysiology.

Adolescent↗

Diagnostic accuracy of endoscopic retrograde cholangiopancreatography in hepatic, biliary, and pancreatic malignancy.

This paper reports the radiographic findings in 84 cases of biopsy-proven pancreatic and biliary malignancies studied by endoscopic retrograde cholangiopancreatography. In the 73 successful studies a diagnosis of tumor could be made in 67 patients (92%). The study was successful in 40 of 43 patients with pancreatic carcinoma and the diagnosis could be made in 37 on the basis of stenosis or obstruction of the ducts. There were 33 successful studies in the 41 patients with miscellaneous tumors including primary bile duct, ampullary, gallbladder, metastatic carcinoma, lymphoma, and hepatoma. A diagnosis of tumor was made in 30 studies. As has been observed in carcinoma of other hollow structures, the hallmark of malignancy in the pancreatic and biliary tract is obstruction and stenosis. This study indicates that malignant disease of the pancreas and tract is accurately assessed by this endoscopic method.

Bile Duct Neoplasms↗

Lacunary pooling in ERCP.

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Cholangiopancreatography, Endoscopic Retrograde↗

Choledocholithiasis.

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Cholangiopancreatography, Endoscopic Retrograde↗

Gallbladder carcinoma: radiologic-pathologic correlation.

Primary carcinoma of the gallbladder is an uncommon, aggressive malignancy that affects women more frequently than men. Older age groups are most often affected, and coexisting gallstones are present in the vast majority of cases. The symptoms at presentation are vague and are most often related to adjacent organ invasion. Therefore, despite advances in cross-sectional imaging, early-stage tumors are not often encountered. Imaging studies may reveal a mass replacing the normal gallbladder, diffuse or focal thickening of the gallbladder wall, or a polypoid mass within the gallbladder lumen. Adjacent organ invasion, most commonly involving the liver, is typically present at diagnosis, as is biliary obstruction. Periportal and peripancreatic lymphadenopathy, hematogenous metastases, and peritoneal metastases may also be seen. The vast majority of gallbladder carcinomas are adenocarcinomas. Because most patients present with advanced disease, the prognosis is poor, with a reported 5-year survival rate of less than 5% in most large series. The radiologic differential diagnosis includes the more frequently encountered inflammatory conditions of the gallbladder, xanthogranulomatous cholecystitis, adenomyomatosis, other hepatobiliary malignancies, and metastatic disease.

Diagnosis, Differential↗

Biomechanics of the human epiglottis.

The mechanism that folds the epiglottis down over the closed larynx in the course of swallowing has been unclear. Measurements of the force needed to fold the epiglottis in cadaver specimens exceed the estimated force available from the aryepiglottic muscle. Frame-by-frame analysis of cinefluorograms reveals that deglutitional epiglottic downfolding occurs at the time of maximal elongation of the hyoepiglottic ligament. The observations lead us to propose a conical model of epiglottic downfolding which also explains the conical shape of the epiglottis usual in early infancy. The infant shape may be part of a protective partially closed entrance adaptive to suckling, while maturational widening of the opening adapts to the growing respiratory demands of increasing physical exertion.

Adult↗