Identifier: radiographyradio01knox (find matches)
Title: Radiography and radio-therapeutics
Year: 1917 (1910s)
Authors: Knox, Robert, 1868-1928
Subjects: Radiography Radiotherapy
Publisher: New York : Macmillan
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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simple ulcer involving only the gastric mucosa being themost difficult to distinguish. Perforating ulcers that involve the muscularwall can be recognised in a much larger percentage of cases, while perforatingulcer of the callous type can be detected in the majority of cases. Chroniculcers with or without perforation that have produced contractions, presenta picture of hour-glass contraction, and are easily recognised. Care should be taken to watch the meal entering the stomach. Hour-glass contraction can readily be recognised, and the presence of a narrowcanal between the two segments is diagnostic. A large shadow in the uppersegment is often clearly seen, soon a fine pencil of bismuth may be detectedpassing through the stricture, and later the whole of the meal may be locatedin the lower segment. This class of case must be differentiated from themalignant hour-glass contraction and the intermittent and pseudo hour-glass contraction. Perforating hour-glass contraction, which has not
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PLATE LXVII.—Stiimach showing Obstbi-ction at Pyloius. a. Stomach showing inaiketl delay in emptying time, due to cicatricial contraction at pylorus. Diag-nosis, pyloric ulcer, confirmed at operation. h, Showing prolonged ilelay at pylorus. Note irregular outline ami narrow channel. Diagnosis,carcinoma of pylorus, operable. Coutirmed at operation, tumour e.xcised. r, Marked delay iu emptying of stomach, narrow channel connecting stomach and duodenum.Diagnosis, cicatricial contraction at pylorus, due to gastric ulcer, confirmed at operation. ULCER OF THE STOMACH 345 changed the form of the stomach through the contraction of scar tissue, isthe most readily diagnosed ulcerative condition, except hour-glass contrac-tion. Haudek first established their radiographic diagnosis, and has formu-lated their Rontgenologic symptom complex and signs as follows : (1) A diverticular projection from the stomach shadow, mostly on thelesser curvature. (2) Movahility of the bismuth mass by palpation. (

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