. Journal of radiology . hown. Where in-testinal obstruction is present, as a re-sult of old adhesions, this method willprobably not serve to localize the siteof obstruction any more accurately thanthe ordinary methods. When inflam-matory lesions are present as a resultof subacute peritonitis the condition canbe readily recognized, since the intes-tines, instead of being easily displacedwith changes in posture, are fixed inposition. We have had several suchcases and have no reason to believe thatinduction of pneumoperitoneum underthese circumstances has any deleteriouseffect. The contents of h
. Journal of radiology . hown. Where in-testinal obstruction is present, as a re-sult of old adhesions, this method willprobably not serve to localize the siteof obstruction any more accurately thanthe ordinary methods. When inflam-matory lesions are present as a resultof subacute peritonitis the condition canbe readily recognized, since the intes-tines, instead of being easily displacedwith changes in posture, are fixed inposition. We have had several suchcases and have no reason to believe thatinduction of pneumoperitoneum underthese circumstances has any deleteriouseffect. The contents of hernias, especiallyventral hernias of the anterior abdomi-nal wall, can usually be establishedwithout difficulty, pneumoperitoneumdisclosing either the gas filled hollowviscus, or the dense omental the operative findings are notknown and there is a suspicion of ma-lignancy of a stomach involved in apost-operative scar or hernia, thismethod gives excellent information, notonly as to the possibility of malignant. Figure IV.—On rolling the patient still farther on the side, the pyloric por-tion and pyloric ring became visible. Note the adhesions of the pyloric por-tion of the stomach to the gallbladder fistula. 41 PNEUMOPERITONinvolvement, but also as to the portionof the stomach involved in the herniaor adherent to the scar. In examination of the large bowelit is extremely necessary to acquaintoneself with the appearance of the nor-mal before undertaking any inferencesof pathology. When the patient isplaced upon the left side, in the lateralposition, the ascending colon sags freelyto the midline in almost its entire extentwith the exception of the coecum. Itis well known that there is wide varia-bility of motion at the coecum in dif-ferent individuals, so that the extentof normal mobility can be determinedonly after many examinations. Thismethod will, however, give informationas to the extent of passive mobility ofthe coecum, and where a subacute ap-pendiceal mass is
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