Relation of lesions of the small intestines to disorders of the stomach and cap as observed roentgenologically / by Lewis Gregory Cole.

  • Cole, Lewis Gregory, 1874-1954.
Date:
1914
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Licence: In copyright

Credit: Relation of lesions of the small intestines to disorders of the stomach and cap as observed roentgenologically / by Lewis Gregory Cole. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    in roentgenograms made previously and subsequently (Fig. 5, a and 5, b). If the cap is quickly evacuated by duodenal peristalsis, its outlines will remain indistinct or invisible until a relaxation of the pyloric sphincter opens the passage from the pars pylorica through which the cap is resupplied with contents. In spite of Kreuzfuch’s reports to the contrary, my observations have been that the gastric peristalsis may be just as active while a spasm involves the pyloric sphincter as it is when the sphincter is functionating normally. Fig. 6.—Spasmodic constriction of cap, caused by chronic appendicitis. Proved by operation. Spasm of the Cap. Constriction of the cap from spasmodic contraction presents roentgenographical evidence similar to that caused by a spasm of the colon. The cap has the appearance of having been twisted or wrung empty of its contents, only a sugges- tion of its bismuth impregnated contents being visible, caught or entangled under the constricting folds. As a result the distorted lumen casts a corrugated or fluted shadow on the roentgenograms (Fig. 6). An interesting case of this kind, presenting definite symptoms of ulcer of the cap, was referred to me from a hospital for the sake of increasing the number of my postpyloric ulcer cases. The clinical history was so typical that I economized by making only about half the usual number of roentgenograms. Even this limited series proved enough to justify a negative diagnosis of chronic indurated duodenal ulcer, that is, an ulcer indicating