. The American journal of roentgenology, radium therapy and nuclear medicine . rary. A true diverticulum is perman-ent. Again, study with the fluoroscope andbarium enema will show that these haustralshadows are within the lumen of the gut andare not extramural, as is the case with thediverticulum. Second, in a certain type of individualsthe colon contents become subdivided intosmall discrete masses, particularly in the de-scending colon and sigmoid. A spastic typeof constipation frequently produces this con-dition. These small masses may be confusedwith diverticula. The inconstancy of thesesha
. The American journal of roentgenology, radium therapy and nuclear medicine . rary. A true diverticulum is perman-ent. Again, study with the fluoroscope andbarium enema will show that these haustralshadows are within the lumen of the gut andare not extramural, as is the case with thediverticulum. Second, in a certain type of individualsthe colon contents become subdivided intosmall discrete masses, particularly in the de-scending colon and sigmoid. A spastic typeof constipation frequently produces this con-dition. These small masses may be confusedwith diverticula. The inconstancy of theseshadows is the chief means of differentiation. Group 2.—The second group in theclassification of diverticulitis is composed ofcases showing beginning secondary changesof an inflammatory nature. The diverticulain this group are usually localized along thelower descending colon and sigmoid. Thepatients invariably have more or less definitesymptoms. The .r-ray plate shows numerous divertic-ula ranging from four or five to twenty, sit-uated in a limited region about the junction. I Fig. 22. Multiple Diverticula with Chronic In-flammatory Changes. Plate taken after a bariumenema. Narrowing of intestine from A to showed tumor mass composed ofchronic inflammatory tissue. Class III. The Roentgen Ray in Diverticulitis of the Colon 507 of the sigmoid and descending colon(Figs. 13-19)- The amount of intestine involved is notmore than two or three inches. The im-portant radiographic appearance differen-tiating this from the preceding group is abeginning narrowing of the lumen of theintestine. The apparent narrowing may atfirst be wholly due to spasm. It is usuallybest observed following the barium the enema fails to reveal thisspastic condition. In later cases, wherethere is actual thickening about the colonwall, the narrowing is constant both withthe meal and enema. Under the fluoroscopic screen there isusually found localized tenderness. Thesigmoid may be fixed
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