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
Catalogue details

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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    Permanent Changes in the Pars Pylorica, Pyloric Sphinc- ter, and Cap. All of the findings described thus far have been direct evidence of the spasm itself. Let us now consider the roentgenological findings of those permanent changes which result from long-continued spasms of the pars pylorica, pyloric sphincter, and cap. Fig. 8.—Permanent changes in pyloric sphincter, caused by constant spasmodic constriction, a reflex from chronic appendicitis. Proved by operation. Frequent spasm of the pars pylorica causes a contraction of the muscular coat, and a consequent diminution of the lumen of this region as compared with lumen of the pars media and pars cardiaca. The mucosa and submucosa heap up into deep folds and attain a permanently puckered appearance, such as they formerly presented only when dominated by a spasm. The region lacks pliability, presenting unusually broad peristaltic contractions, but exhibits a regular systole and diastole (Fig. 7). The result of spasm of the pyloric sphincter is not quite so char- acteristic. It may be described as a puckering resembling the folds near a purse string that had been tightly drawn, and is most prominent during the stage of diastole, when the adjacent tissue is completely relaxed (Fig. 8). The sphincter may be thicker than normal, but at some stage of digestion its lumen should be distinctly shown. The roentgenological findings of permanent changes resulting from spasm of the cap are so similar to those of postpyloric ulcer that the two conditions are sometimes difficult to differentiate.