. The American journal of roentgenology, radium therapy and nuclear medicine . esting factor in the historyat this period of his illness, was thatwalking or standing relieved this temporaryindisposition on the part of the digestiveapparatus. In the latter part of his illnessthe patient began to experience pains inthe back during the late sleeping hours ofthe night and suffered from did not relieve the stomach distressnor did the pains appear at any specialtime after eating. Past History.—Patient had typhoid atage of 14; malaria ten years ago; and hashad many subsequent attacks
. The American journal of roentgenology, radium therapy and nuclear medicine . esting factor in the historyat this period of his illness, was thatwalking or standing relieved this temporaryindisposition on the part of the digestiveapparatus. In the latter part of his illnessthe patient began to experience pains inthe back during the late sleeping hours ofthe night and suffered from did not relieve the stomach distressnor did the pains appear at any specialtime after eating. Past History.—Patient had typhoid atage of 14; malaria ten years ago; and hashad many subsequent attacks since. Family History.—Negative. Habits.—Does not use alcohol. Is veryfond of dogs. Physical Examination.—Physical exam-ination was negative and the patient wasreferred to the .v-ray laboratory for agastro-intestinal examination. Roentgenological Examination.—\^iewedin the anteroposterior position the cystwas visualized quite plainly in the fluoro-scopic screen occupying a position in theinferior portion of the chest cavity sometwo centimeters above the Fig. 2. Roentgenogram Taken in the Postero-anterior Position. Echinococcus Disease 515 The lateral diameter of the cyst was com-puted to measure about twelve centi-meters and the vertical about ten centi-meters. Stereoscopic plates were taken andfrom these we advanced the opinion thatthe cyst was connected to the was made that the cyst bepunctured under guidance of the fluoro-scopic screen, but we advised against thisprocedure as we were afraid of producingan anaphylactic shock and endangeringthe life of the patient. Miraillie collectedforty-three cases in which simple puncturewas performed with two cures, twenty-twodeaths, and ten negative results. Accord-ing to Dieulafoy there is only one pro-cedure to follow in these cases and that ispneumotomy. A cure is obtained in aboutninety per cent of operations. Operation.—On November 19. 1917, thepatient was given a nitrous oxide anes-
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