The Röntgenologic diagnosis of surgical lesions of the stomach and duodenum / by George Emerson Brewer, M.D. and Lewis Gregory Cole, M.D. of New York City.

  • Brewer, George Emerson, b.1861
Date:
[1915?]
Catalogue details

Licence: In copyright

Credit: The Röntgenologic diagnosis of surgical lesions of the stomach and duodenum / by George Emerson Brewer, M.D. and Lewis Gregory Cole, M.D. of New York City. Source: Wellcome Collection.

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    Rontgenologic Diagnosis.—There is no evidence of new growth involving the stomach itself. An obstruction presents at the pylorus, involving either the first portion of the duodenum or the pyloric sphincter, or both. The lesion probably is due to a duodenal ulcer, either old or new. Considering the immense prog- nathian dilatation of the stomach, and the retention of food, there is no question but that surgical procedure is definitely indicated. Surgical Findings.—The stomach was enormously dilated. A • hard indurated mass, one-half inch in diameter, extended on to first portion of duodenum. A gastro-enterostomy was performed. Case XXIV.—Clinical History.—M. M.; woman. Indigestion since childhood after tiring work. Occasional sharp attacks of colic in upper abdomen of late. Epigastric distress, occurring after meals, about n a.m. and 5 p.m., and after retiring at night. Considerable loss of weight. Rontgenologic Diagnosis.—There is no evidence of carcinoma or indurated ulcer of the stomach itself. The constant deformity of the cap, viz., the permanent indentation in the upper edge and the pouching of the lower portion, indicates a definite lesion in the upper portion, either from a duodenal ulcer or gall-bladder infection, with the weight of the evidence in favor of the former. Surgical Findings.—The stomach was found to be normal. A small, shot-like induration presented on the posterior wall of the duodenum, ^4 inch from the pylorus. A gastro-enterostomy was performed. Case XXV.—Clinical History.—J. P.; man; age forty. The patient had dysentery in 1899. Since 1905 has had chronic indi¬ gestion, hunger pains, occasional severe pain in epigastric area after eating, with more or less soreness in appendicular region. Rontgenologic Diagnosis.—No evidence of new growth or in¬ durated ulcer of the stomach or duodenum can be detected. The contraction of the cap and the extreme pyloric end of the stomach is probably due to a spasm or possibly to adhesions. The flatten¬ ing of the left side of the ascending colon, the incomplete distention of the caecum, the insufficiency of the ileocaecal valve, with the distended coils of small intestine pressing on the left side of the ascending colon up to the region of the gall-bladder, are suffi¬ cient to cause the spasm of the stomach and cap. Surgical Findings.—The stomach and duodenum were normal. Two small adhesions passed from the summit of the gall-bladder and duodenum to the liver. An adherent, thickened and angu- lated appendix was removed. Case XXVI.—Clinical History.—N. R.; woman; age twenty. Six months ago the patient first began to complain of pain in epigastrium, coming on 2 or 3 hours after meals, gnawing in
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