Abstract
(1) An account is given of the technique found most
suitable for the radiological examination of
cases after gastro-enterostomy.
(2) The mode of filling and action in the normal
stomach, and after gastro-enterostomy is described.
(3) It is suggested that there is a patulous condition of the stoma in the fasting stomach, allowing
the leakage of the gastric secretion,
especially in the recumbent position and that
this may be at least a partial explanation of
the improvement following gastro-enterostomy.
(4) It is pointed out that in the full stomach ther
is a rhythmical action of the stoma, and that
this is probably due to variations in the gastric
tone.
(5) As there is every evidence that primary union
rarely takes place at the anastomotic line,
puckering of the mucosa will normally be present
and can have no diagnostic significance.
(6) The only radiological evidence of gastro-jejunal
ulcer is the actual demonstration of a "niche".
(7) It is pointed out that while a well formed
"niche" sign is diagnostic of gastric, duodenal
or gastro-jejunal ulcer, the disappearance of
this sign can in no way be taken as evidence
that the ulcer has. healed.
(8) The diagnosis of carcinoma developing in a
stomach after gastro-enterostomy is exceedingly
difficult by the opaque meal, and it is suggested
that the onset of symptoms will be unusually
late. A negative X-Ray report of neoplasm in
these cases is of no value.
(9) In every examination of a stomach after gastro-enterostomy, mention should be made of the position
of the colon, preferably in relation to
that of the anastomosis.
