International clinic week at the New York Polyclinic Medical School and Hospital during the International Surgical Congress, April, 1914 / by Alfred C. Jordan [and others].

Date:
1914
Catalogue details

Licence: In copyright

Credit: International clinic week at the New York Polyclinic Medical School and Hospital during the International Surgical Congress, April, 1914 / by Alfred C. Jordan [and others]. 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.

    10/106 (page 8)
    November 22, 1913). In the vertical posture the emulsion is seen to pass through the esophagus rapidly, and to fall at once to the great curvature of the stomach. The patient then lies on the couch on his right side to allow the bismuth to fill the pylorus and duodenum. After a minute or so he lies on his back, and is examined with the fluorescent Fig. 1.—Simple ileal stasis, taken on the couch 37 hours after a bismuth meal in a woman aged 40 suffering from advanced cystic disease of the breasts. screen. In the normal case the duodenum is small and short, its vertical portion measuring 23/4-31/4 inches; in a few seconds a duodenal peristaltic wave starts near the top of the duodenum, and carries before it the whole contents of the duodenum with- out delay through its four parts and on to the jejunum. At the end of three or four hours there is no longer any bismuth in the stomach or duo- denum; the whole of it is in the lower abdomen, partly in the lower coils of the ileum, partly in the cecum and ascending colon. In perfectly normal cases the lower ileal coils lie above the pelvic brim, and there is never a very large collection of bismuth in these coils, the passage through the ileocecal valve being free. One of the very earliest effects of stasis is to cause the lower ileal coils to drop into the pelvis. There is then a long rise from the pelvis to the cecum. Spasm of the ileocecal valve occurs, and adds to the difficulty. The last inches