Identifier: americanjournroen07ameruoft (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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tomach Above Diaphragm. \Vhen fluoroscoped in the prone positionthese findings were confirmed. This ofcourse suggested the possibility of encapsu-lated fluid in the lower portion of the leftchest. The patient was then fluoroscoped inthe erect position and what previously hadappeared to be a sharp outline of the upperborder of the area of increased density, wasseen to be a definite line convex upward, andbelow this line a very sharp clearly markedfluid level was seen. This fluid was seen topulsate with the pulsation of the heart. Thefluid line changed with a change of positionof the patient and continued to transmit thecardiac pulsations. The cardiac shadow wasslightly displaced to the right. The left lungwas forced upward and contained less airthan the right. On deep inspiration there was 252 Hernia of the Diaphragm a definite lagging of the left side of thechest; the interspaces did not change to asgreat a degree on the left as on the right,and the convex line in the lower portion of
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Fig. 2. Shows Patient Standing with UpperBorder of Stomach as Convex Line and aFluid Retained in Stomach. the chest remained stationary. This convexline appeared to be about the level of the The patient was then fluoroscoped whiledrinking Barium Sulphate in buttermilk.The opaque meal passed down the esopha-gus normally, passing through the cardiaand entering the stomach in the median line.As the barium filled the stomach a sacculatedshadow appeared to the left of the medianline. This shadow of the barium did not fillthe stomach in the usual position in the ab-domen but formed a pouch to the left of themedian line and then passed upward througha constricted portion. (Fig. 3.) As the patient continued to drink theBarium the pouch in the abdomen grewlarger and the opaque substance was seen topass more readily through the constrictedportion and then fill another pouch above thefirst. As this took place the fluid line in thethorax was seen to rise definitely until itmerged with the convex

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