File:The American journal of roentgenology, radium therapy and nuclear medicine (1906) (14754655394).jpg

Identifier: americanjournroen06ameruoft (find matches)
Title: The American journal of roentgenology, radium therapy and nuclear medicine
Year: 1906 (1900s)
Authors: American Radium Society American Roentgen Ray Society
Subjects: Radiotherapy X-rays
Publisher: Springfield, Ill. C.C. Thomas
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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iaphragm, andappeared to be surmounted by a trans-parent rounded cavity. This made us thinkfirst of a possible collection of air and fluidin the pulmonary field. The ingestion of anopaque meal showed clearly that we weredealing with the stomach, which presenteda supradiaphragmatic and subdiaphrag-matic i)ortion, united by a constriction Radiological Diagnosis of Transdiaphragmatic Hernia of the Stomach 379 corresponding to the level of the dia-phragm. The upper portion filled first,from below upwards. (Fig. 2.) The exami-nation in the horizontal position gave theexplanation of this anomaly. The opaquebolus which cams down the esophaguswould go up above the diaphragm, andthen the pyloric portion would afterwards three horse-hair sutures. At present thepatient is entirely well, and his stomachfunctions normally. The latter was provedby another radiological examination. Case II.—Sub-Lieutenant P. was sentto us a short time later, in July, 1917. Hehad been woimded eight months before by
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p-lG. 4. fill. It was obvious that the middle portionof the stomach had been drawn up throughthe hole in the diaphragm, while thecardia and pylorus remained fixed below. (Fig 3-) The emptying of the stomach was con-siderably delayed. Twenty-foiir hours after-ward it still contained opaque liquid. OnJuly 4, 1917, Professor Walther operatedby the thoracic approach, freed up theadhesions between the pleura and theherniated stomach and omentum, andreduced the hernia into the abdomen. Thediaphragmatic opening was closed with a shell fragment, which penetrated the leftside of his chest, traveling from abovedownwards, and from behind forwards.An attempt had been made to find thefragment through the wound of entrance,but without success. After the pleuraleffusion had slowly absorbed and thewound had healed, the patient was sentaway to convalesce. His general conditionhowever remained poor. He presented anextreme emaciation, and complained ofdifficulty in breathing, as well as of dys-peptic di

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