. A text-book of radiology . ver the site of theconstriction, and with all these points to guide us the diagnosisof gastric ulcer will be reason-ably safe. Ulcers of the fundusare rare and may be classedamong the pathologicalcuriosities. It should be stated that hyper-secretion is more often found incases of ulcer of the pyloric fluid is highly acid, and thismay be proved by giving a dose ofbicarbonate of soda and watch-ing the rapid formation ofgas in the fundus. According to Barclay a diagnosis ofpyloric ulceration may be suggested if—the stomach isnormal, the peristalsis is rather a
. A text-book of radiology . ver the site of theconstriction, and with all these points to guide us the diagnosisof gastric ulcer will be reason-ably safe. Ulcers of the fundusare rare and may be classedamong the pathologicalcuriosities. It should be stated that hyper-secretion is more often found incases of ulcer of the pyloric fluid is highly acid, and thismay be proved by giving a dose ofbicarbonate of soda and watch-ing the rapid formation ofgas in the fundus. According to Barclay a diagnosis ofpyloric ulceration may be suggested if—the stomach isnormal, the peristalsis is rather active, no shadows areseen passing through the duodenum, and there is rapidsecretion which gives off C02 freely. It should beremembered that various stages of atony may beassociated with gastric ulceration. Pyloric obstruction is further recognised by the factthat in spite of more or less active peristalsis the stomachshows no sign of emptying within an hour. Normallyall should have left the stomach in about four hours. Six. Fig. 67. Hour-Glass Stomachwith pyloric obstruction. 176 TEXT-BOOK OF RADIOLOGY. hours is too long, but not necessarily due to pyloricobstruction, especially if atony is present to any food remains after eight hours in a stomach notmarkedly atonic and in spite of active peristalsis, we maybe sure there is obstruction of the pylorus. There are no characteristic signs by which we mayrecognise malignant disease of the stomach from otherforms of ulceration and obstruction. The chief point is avery unusual course taken by the food after it enters thestomach, due to the inroads of the growth. Examinationon a subsequent day shows the irregularity to bepermanent. If hyper-secretion be present, little or noevolution of gas takes place after giving bicarbonate ofsoda. The shape of the stomach shadow may be altered byadhesions as well as growths on other parts affecting it bypressure from without. All these conditions call for con-siderable experience if a
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