. The American journal of roentgenology, radium therapy and nuclear medicine . n elastic tubethat is frequently changing its position,that is overhung and obscured by loops ofiliac colon and that is alternately contract-ing and dilating in a rhythmic inconstant and ever-changing ana-tomic relationships make it impossibleto establish normal standards. The opaque meal (feed test) is absolutelyunreliable, inasmuch as it will frequentlygive the impression of contracture or atonyof the bowel when, as a matter of fact, theroentgenogram merely portrays the tem-porary physiological phase o
. The American journal of roentgenology, radium therapy and nuclear medicine . n elastic tubethat is frequently changing its position,that is overhung and obscured by loops ofiliac colon and that is alternately contract-ing and dilating in a rhythmic inconstant and ever-changing ana-tomic relationships make it impossibleto establish normal standards. The opaque meal (feed test) is absolutelyunreliable, inasmuch as it will frequentlygive the impression of contracture or atonyof the bowel when, as a matter of fact, theroentgenogram merely portrays the tem-porary physiological phase of relaxationor contracture. By means of the opaque enema roent-genologists have established quite definite standards, and are able to distinguishvarious fixed types of colon. The enema,however, canalizes the rectosigmoid regioneven in cases of spasm; the colon graduallyfills, and finally the enema fluid distendsthe rectum as well as the in the rare instances in which thisregion will be visualized on the plate, nonarrowing or contracture will be Fig. 15. Barium enema showing absence of rectosigmoidapparatus. This appears to be a definite type of colonin which there is no line of demarkation between therectum and pelvic colon. We consider it a character-istic type. The resulting constipation is exceedinglyobstinate in character. It is, therefore, obvious that sigmoidos-copy is the only reliable method by whichthe condition of the rectosigmoid apparatuscan be ascertained. We have, however,been able to secure quite good views of therectosigmoid region by the followingmethod: The patient is placed in the knee-chest posture and insufflations of bismuthsubcarbonate made by means of a powderblower through the sigmoidoscopic is then placed in the dorsal positionand immediately plated (Figs. 9, 10 and11). Very excellent views of the recto-sigmoid may at times be secured in patientswho have had severe pelvic inflammatory 420 Roentgenological Findings
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