. The American journal of roentgenology, radium therapy and nuclear medicine . hcame under the notice of the shadows were shown. It wasdetermined definitely that a large shadowin the renal region was due to a calculusfilling the renal pelvis and extending intothe calices. At the lower limit of the renalcalculus a large oval shadow was had a central opacity surroundingwhich was a less opaque area, and at theextreme periphery an irregularly denseoutline was seen. (Figs. 12 and 13.) Doubt tound to contain large calculi in branchingarrangement. The gall-bladder was opene
. The American journal of roentgenology, radium therapy and nuclear medicine . hcame under the notice of the shadows were shown. It wasdetermined definitely that a large shadowin the renal region was due to a calculusfilling the renal pelvis and extending intothe calices. At the lower limit of the renalcalculus a large oval shadow was had a central opacity surroundingwhich was a less opaque area, and at theextreme periphery an irregularly denseoutline was seen. (Figs. 12 and 13.) Doubt tound to contain large calculi in branchingarrangement. The gall-bladder was openedby the anterior route, and one large andfifty small stones were remo\ed. Theexamination in this case shows how verythorough must be the technique whendoubtful conditions exist. In the radio-grams taken in the anteroposterior and theposteroanterior positions, several faintshadows due to biliary calculi were seen,but the majority of the small biliary cal-culi were lost in the renal shadow and thatof the kidney stone. The lateral positionand the opaque catheter gave much help. Fig. 16. Lateral view of branching kidn ey ealciui. arose regarding this shadow, although itcertainly had the characteristic appearanceof a large gall-stone. In the anteroposteriorview first taken, it was overlapped in partby the calculus in the kidney, and theshadow of the kidney also overlapped it. Butin a subsequent exposure it lay below theshadow of the kidney stone. An opaquecatheter was introduced into the passed the lower shadow and entered thekidney at the upper limit of the renal cal-culus. A lateral radiogram showed clearlythat the doubtful shadow lay in front of thespine, and the diagnosis of gall-stonewas made. At operation the kidney wasremoved by the lumbar route, and was Fig. 17. Lateral \ie\v of stone in calyx showing stoneshadow behind the vertebral bodies. in the diagnosis. Stereoscopic radiogramswould have been useful in this case, thoughit is doubtful if one could have made any
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