Barium-Spray Examination of the Stomach–Preliminary Report of a New Roentgenographic Technic

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THE mainstay of the radiographic study of the upper gastrointestinal tract has been the abdominal roentgenograms after barium swallow. There are frequent occasions when the radiographic configuration of the stomach after barium swallow will not allow differentiation between a normal and a pathologic stomach. Newer diagnostic procedures have been developed to aid in diagnosing gastric lesions; these include gastroscopy, gastric cytologic examination, and angiography. The purpose of this report is to give the preliminary experience with another technic of gastric examination using barium spray.

The roentgenographic barium-spray examination of the stomach is a technic whereby roentgenograms of the abdomen are made after barium is nebulized into the stomach through a special tube, and a double-contrast study of the mucosa of the stomach is obtained. This procedure was used to examine 25 patients during this last year at the Cleveland Clinic Hospital. In each of four patients a pneumo-peritoneum also was induced by the technic of Frimann-Dahl and Traetteberg1 and a triple-contrast study of the stomach was made.

The need for additional roentgenographic study was most frequent in patients with suspected lesions in the fundus and cardia of the stomach. The inaccessibility of the gastric fundus to the roentgenologist’s palpating hand and the absence of visible peristalsis in the proximal part of the stomach necessitate further diagnostic approaches for this region. Unfortunately the gastric fundus is also inapproachable by the present technic of gastroscopy. The wide variation in tone of the proximal part of the stomach among patients produces numerous distorted . . .



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