Preliminary report on the diagnosis of postpyloric (duodenal) ulcer by means of serial radiography / by Lewis Gregory Cole.

  • Cole, Lewis Gregory, 1874-1954.
Date:
1913
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Licence: In copyright

Credit: Preliminary report on the diagnosis of postpyloric (duodenal) ulcer by means of serial radiography / 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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    Reprinted from the New York Medical Journal for May io, 1913. PRELIMINARY REPORT ON THE DIAGNO- SIS OF POSTPYLORIC (DUODENAL) ULCER BY MEANS OF SERIAL RADIOGRAPHY* By Lewis Gregory Cole, M. D., New York. The frequency with which postpyloric (duodenal) ulcers occur, unrecognized by clinicians and even by surgeons at the time of operation, is one of the marvels of the present medical age. The clinical and surgical aspects of this subject have been care- fully considered by Wier, Moynihan, Codman, Xlayo-Robson, the Mayo brothers, and others; but the radiological contributions have been rather in- conclusive, and are limited to those by Bier, Kreuz- fuchs, Strauss, and Ashbury (gastric and duodenal ulcers). Two methods have been employed by these observers. One depends on the contention that bismuth will adhere to the surface of an ulcer, or become incarcerated in its crater. But the fail- ure to differentiate these “flecks” of bismuth from normal retention in the cap, and the fact that they occur very infrequently, are the weak points in this procedure. The second method is the study of symptom complices, which, as the name suggests, are only groups of symptoms, recognized by radi- ography or fluoroscopy. The method to be described herein depends on recognizing the actual deformity of the gut, caused by the induration or cicatricial contraction surround- ing an ulcer. Before one attempts to make a diag- nosis of postpyloric (duodenal) ulcer by this meth- od of examination he must thoroughly comprehend the normal aspects of the cap (pilleus ventriculi), 'Head before the Syracuse Academy of Medicine, April 5, 1913. Copyright, 1913, by A. R. Elliott Publishing Company.