. Roentgen interpretation; a manual for students and practitioners . Incisura. Pijlomis Fig. 145.—Malignant disease of the lesser curvature. 168 GASTRO-INTESTINAL TRACT Motility.—The normal stomach empties in three to six hours,depending upon the amount and composition of the meal, the toneof the stomach and its functional activity. If it empties in less thanthree hours, ach^^ia, an incompetent pylorus, duodenal ulcer orgall-bladder disease is suggested. If there is a definite residue(one-quarter of the original meal) beyond six hours and the patienthas taken no food or drugs in the meantime,
. Roentgen interpretation; a manual for students and practitioners . Incisura. Pijlomis Fig. 145.—Malignant disease of the lesser curvature. 168 GASTRO-INTESTINAL TRACT Motility.—The normal stomach empties in three to six hours,depending upon the amount and composition of the meal, the toneof the stomach and its functional activity. If it empties in less thanthree hours, ach^^ia, an incompetent pylorus, duodenal ulcer orgall-bladder disease is suggested. If there is a definite residue(one-quarter of the original meal) beyond six hours and the patienthas taken no food or drugs in the meantime, one must suspect a. Fig. 146.—Tracing of the stomach, showing annular constriction of the media ckie to cancer. lesion in the stomach, reflex irritation of the pylorus (duodenum,gall-bladder, appendix) or obstruction in the intestine below. Inrare instances delay may be due to acute illness, marked ptosis orthe action of certain drugs. Carcinoma.—Because of the insidious onset of carcinoma, thepatients do not appear for examination until there is a well-estab-lished lesion so that few early ones are found. The characteristicfindings are defects in outline, absent, sluggish, irregular or reversed STOMACH 169 peristalsis, esophageal or gastric stasis (or early gastric emptying)and loss of flexibility of stamach wall. The appearances seen varyconsiderably with the t}^e of growth and with its location. Car-cinoma of the cardia is often difficult to visualize. In these casesit is helpful to watch the first mouthfuls of barium entering thestomach. The jet will be irregular instead of smooth and theremay be
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