Clinical Medicine Tuesday Clinics At the Johns Hopkins Hospital

Cover Clinical Medicine Tuesday Clinics At the Johns Hopkins Hospital
Clinical Medicine Tuesday Clinics At the Johns Hopkins Hospital
Barker, Lewellys F. (Lewellys Franklin), 1867-1943
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DR. BARKER: Let us look at these #-ray plates as they stand on the illuminating screen. You see that the outlines of the stomach and of the duodenum seem perfectly normal. The passage of the barium through the small intestine presents nothing particularly abnormal. The great dilatation of the cecum and ascending colon, however, in the five-hour plate and in the fifteen-hour plate is strik- ing. You notice that just above the accumulated barium there is a narrow strip showing that a little bariu
...m is going through a con- stricted portion of the intestine. At the flexura coli dextra the air- containing, dilated, transverse colon begins, and a little barium can be seen in this, in the rest of the colon, and in the rectum. You notice that the character of the diminution of caliber of the ascend- ing colon indicates a concentric constriction. If this obstruction were due to some mass causing direct pressure from the outside we should expect a less symmetrical constriction. Moreover, the obstruction can scarcely be due to anything within the lumen of the intestine.

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