Identifier: americanjournroen08ameruoft (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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ationof this mass to the ureter an injection ofthorium was made into the kidney pelvisand a ()late was made showing the smoothgentle curve of the ureter. A second platewas then made while exerting upward andinward pressure on the mass with a cone,and the radiograph showed a distinct kink-ing of the ureter, suggesting that the masswas retroperitoneal and that the ureterpassed anterior to it. Destruction of thebodies of the 4th and 5th lumbar was noted,and the possibility of the mass being a tuber- 129 I30 Retroperitoneal Masses Detected by Pneumoperitoneum cular abscess was at once considered. In aneffort to demonstrate the origin of the massmore clearly, the patient was examined in aprone position (Fig-, i). chest and thighssupported on two l^locks taking all pressure leaving a clear space between them and theretroperitoneal structures. The liver is at-tached by the triangular ligament to the dia-phragm, and drops forward also, to a greateror lesser extent in different individuals ac-
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FiG. 2. Psoas Abscess Shown in the Retruperitoneal Position- EncroachingUPON the Praevertebr.vl Clear Space. off the abdomen and allowing the anteriorabdominal wall to sag freely between the twosupports. The retroperitoneal character ofthe mass and its complete separation fromthe kidne)S was then clearly shown (Fig. 2),and since the mass originated in the area ofdestruction of the lumbar spine, the diagno-sis of psoas abscess was made, which wasconfirmed by subsequent developments. Since this prone position demonstrated theretroperitoneal origin of the tumor mass soclearly in this case, it was not long beforewe made a closer examination of its possi-bilities in other cases. A moments consid-eration of the anatomical arrangement inthis position may serve better to illustratethe cases which are to follow. (Fig. 3.) Itwill be noted that if the patient is suspendedon two blocks, so as to take all pressure offthe abdomen, the belly wall will sag downand all of the intra-abdominal organs wi

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