File:Archives of physical medicine and rehabilitation (1920) (14734143706).jpg

Identifier: archivesofphysic04ameruoft (find matches)
Title: Archives of physical medicine and rehabilitation
Year: 1920 (1920s)
Authors: American Academy of Physical Medicine and Rehabilitation American College of Radiology and Physiotherapy American Congress of Physical Medicine and Rehabilitation Radiological Society of North America
Subjects: Physical therapy
Publisher: (Chicago, etc.)
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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ema and may be an aidin the detection of cecal lesions. Advantages of the enema are thatit visualizes the colon throughout or tothe point of obstruction, the colonicwalls are expanded to normal or be-yond, so that irregularities of contourare more readily seen, and it is pos-sible to complete the examination withina few minutes (Fig. 2). Schlesingersays that since employing the enema hehas often been able to demonstrate can-cers with such slight symptoms that amalignant growth would hardly havebeen suspected. For several years our routine at theClinic has not varied. On the eveningbefore examination the patient abstainsfrom supper and takes 60 c.c. of castoroil; early the next morning he clears outthe bowel with a warm soapsuds enema.The opaque enema is made up of 240gm. of barium sulphate held in sus-pension by condensed milk and mucilageof acacia, the total quantity being about2 liters. This is warmed to bodytemperature, and, with the patient re-cumbent on the trochoscope, is admin-
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\ Tig- 1 — (Case A-19406)—Ing-ested meal. Irregular aistrlbixtionof barium throughout the colon. No deflnite obstruction, butpeculiar irregularity of descending colon and sigmoid, sug-gesting a lesion. See Figure 2.Pig. 2 (Case A-19406)—Definite obstruction to enema in the sigmoid flexure. At operation cancer of the sigmoid was found. , , ^ rig. 3—(Case A-3S0027)—Cancer of the lower sigmoid. Note the annular filling defect. Fig. 4—(Case A-68010)—Napkin-ring cancer of the transverse colon. istered from a container at a height of0.5 to I m. The enema is watched onthe screen from the moment it entersuntil (iUing is complete, and the abdo-men is manipulated as is necessary toassist observation. One or several platesare made for confirmation, supplemen-tary study, or permanent record, but adiagnosis is never attempted on roent-genographic findings alone (Figs. 3, 4and 5). Roentgenologic Signs Roentgenologic manifestations ofcancer of the colon, as elicited by theopaque enema,

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