The subject - "Peptic Ulceration of the Oesophagus
in combination with Partial Thoracic Stomach" - is one
which has been recognised only within the past few years.
It has been my fortune, as radiologist to a large teaching
hospital, to find over twenty cases during the past five
years. The thesis reviews the pathogenesis and clinical
features together with a description of diagnostic methods
and treatment. The appendix contains full clinical notes
of eighteen cases which have been under treatment and
observation for more than a year.
The clinical importance in recognising the condition
lies in the fact that the alternative diagnosis is cancer
of the lower end of the oesophagus. Peptic ulceration
is not uncommon and if erroneously treated by radiotherapy
the results might prove disastrous.
The academic interest of the subject centres round
the lower end of the oesophagus and the partial thoracic
stomach. The congenital and acquired types of gastric
herniation through the oesophageal hiatus are fully discussed
and the accepted anatomical site of the cardia is called
into question. As regurgitation into the oesophagus plays
a large part in the production of peptic ulceration this
point assumes considerable importance. The recognition of
the position of the cardia in relation to neighbouring structures
is most readily determined by radiology and stress is laid on
the distinguishing features.