. Radio-diagnosis of pleuro-pulmonary affection . had brought about the development of atrue pyopneumothorax of the large cavity. There were,therefore, two superimposed hydroseric cavities. Theinferior one was the herniated stomach which had becomethoracic with its fluid contents, its air chamber, its mobilefluid level; the superior was the true pyopneumothorax ofthe large cavity. It gave the illusion of a double pneumo-thorax, the inferior appearing partial and the superior gave the explanation of this curious picture. 72 RADIO-DUGNOSIS: PLEURA Double pneumothorax.—Cases of this
. Radio-diagnosis of pleuro-pulmonary affection . had brought about the development of atrue pyopneumothorax of the large cavity. There were,therefore, two superimposed hydroseric cavities. Theinferior one was the herniated stomach which had becomethoracic with its fluid contents, its air chamber, its mobilefluid level; the superior was the true pyopneumothorax ofthe large cavity. It gave the illusion of a double pneumo-thorax, the inferior appearing partial and the superior gave the explanation of this curious picture. 72 RADIO-DUGNOSIS: PLEURA Double pneumothorax.—Cases of this type may be com-pared with certain radioscopic images of pneumothorax withfluid effusion showing the presence of two lines of fluid leveldistinct and superimposed. This particular appearance is explained in the followingway. It is a pneumothorax developed in a pleural cavityshowing some adhesions or slight diverticula above thelevel of the effusion. When the patient lies in the dorsal,ventral, or lateral decubitus, a small amount of fluid may. Fig. 18. THORACIC HERNIA OF THE STOMACH, GASTRIC PERFORA-TION, SECONDARY DEVELOPMENT OF A PYOPNEUMOTHORAXOF THE LARGE CAVITY filter towards these adhesions and penetrate the the patient is raised up quickly, the fluid may be retainedin these diverticula, where it forms small pool-like areaswith a movable level of fluid, which give the appearanceof a second independent pneumothorax. Artificial Pneumothorax.—Radiological examinationis indispensable in artificial pneumothorax. Without itthis method of treatment would be practically inapplicable. Introduced into practice by Forlanini, this new therapeu-tic measure met with success and unfortunately with someserious results which awoke the instinctive distrust of phy- PNEUMOTHORAX 73 sicians. It was necessary to make it more exact regardingindications and contra-indications, more careful in inter-vention, and more reserved in after treatment. The physician proposing interve
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