. The American journal of roentgenology, radium therapy and nuclear medicine . d-ing diagonally from below, upward fromposterior axillary line to within 10 cm. of6th dorsal spine. Breath sounds clear andfrequently absent below scar on left also note on percussion is dull andvocal fremitus absent. Abdomen in epigastrium and right hypo-chondriac region. Patient shows pallor; nojaundice; is emaciated and complains ofheartburn and constant pain in after every meal a portion of the meal. A-ray examination of the chestrequested. February 23, 1919, when th
. The American journal of roentgenology, radium therapy and nuclear medicine . d-ing diagonally from below, upward fromposterior axillary line to within 10 cm. of6th dorsal spine. Breath sounds clear andfrequently absent below scar on left also note on percussion is dull andvocal fremitus absent. Abdomen in epigastrium and right hypo-chondriac region. Patient shows pallor; nojaundice; is emaciated and complains ofheartburn and constant pain in after every meal a portion of the meal. A-ray examination of the chestrequested. February 23, 1919, when the roentgenexamination was made the patient was firstexamined by means of a plate while in theprone position, the negative showing a resec-tion of about 7 cm. of the tenth rib pos-teriorly. In this region, extending from thelower border of the eighth ril) was a largerounded mass, showing a diffuse hazy in-crease in density, but a clear area was notedin the costodiaphragmatic angle. The upperIjorder of this area had a definite sharplymarked outline which was convex. (Fig. i.). Fig. I. Shows Shadow in Chest which Proved toBE Pouch of Stomach Above Diaphragm. \Vhen fluoroscoped in the prone positionthese findings were confirmed. This ofcourse suggested the possibility of encapsu-lated fluid in the lower portion of the leftchest. The patient was then fluoroscoped inthe erect position and what previously hadappeared to be a sharp outline of the upperborder of the area of increased density, wasseen to be a definite line convex upward, andbelow this line a very sharp clearly markedfluid level was seen. This fluid was seen topulsate with the pulsation of the heart. Thefluid line changed with a change of positionof the patient and continued to transmit thecardiac pulsations. The cardiac shadow wasslightly displaced to the right. The left lungwas forced upward and contained less airthan the right. On deep inspiration there was 252 Hernia of the Diaphragm a definite lagging of the left sid
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Keywords: ., bookcentury1900, bookdecade1900, bookidamericanjour, bookyear1906
