. The American journal of roentgenology, radium therapy and nuclear medicine . as closed with a shell fragment, which penetrated the leftside of his chest, traveling from abovedownwards, and from behind attempt had been made to find thefragment through the wound of entrance,but without success. After the pleuraleffusion had slowly absorbed and thewound had healed, the patient was sentaway to convalesce. His general conditionhowever remained poor. He presented anextreme emaciation, and complained ofdifficulty in breathing, as well as of dys-peptic disturbances which were not re-liev
. The American journal of roentgenology, radium therapy and nuclear medicine . as closed with a shell fragment, which penetrated the leftside of his chest, traveling from abovedownwards, and from behind attempt had been made to find thefragment through the wound of entrance,but without success. After the pleuraleffusion had slowly absorbed and thewound had healed, the patient was sentaway to convalesce. His general conditionhowever remained poor. He presented anextreme emaciation, and complained ofdifficulty in breathing, as well as of dys-peptic disturbances which were not re-lieved by any treatment. There was pain 38o Radiological Diagnosis of Transdiaphragmatic Hernia of the Stomach after eating, often followed by vomitingof the food eaten. Radiological Examination.—The exami-nation was made in the vertical anteriorposition. Although the patient had eatennothing since the previous evening, adefinite fluid level was observed in theregion of the stomach. The abnormalheight of the fluid-level made us suspecta pleural effusion. The administration of. shown in Fig. 5. A constriction is seen,corresponding to the position of the dia-phragm. Spontaneous mobility was absent,and provoked mobility was much dimin-ished. No localized tenderness was notedon palpation. Palpation was extremelydifficult on account of the high position ofthe stomach under the false ribs. Theshell-fragment was clearly seen in theneighborhood of the vertebral shadow.
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