. The American journal of roentgenology, radium therapy and nuclear medicine . raph(Fig. 4) taken which showed the meal topass down the esophagus into the abdomenand back through the diaphragm into thestomach, none entering the small twentv-four hour radiograph showed al-most complete gastric retention. (Fig. 5.)The portion of the meal that had been re-tained in the esophagus had been diagnosis was made of strangulatedhernia of the stomach through the leftdia]jhragm. Operation showed the stomachto be the onlv abdominal or^an above the patient. The probability was that the
. The American journal of roentgenology, radium therapy and nuclear medicine . raph(Fig. 4) taken which showed the meal topass down the esophagus into the abdomenand back through the diaphragm into thestomach, none entering the small twentv-four hour radiograph showed al-most complete gastric retention. (Fig. 5.)The portion of the meal that had been re-tained in the esophagus had been diagnosis was made of strangulatedhernia of the stomach through the leftdia]jhragm. Operation showed the stomachto be the onlv abdominal or^an above the patient. The probability was that the severevomiting forced the stomach through asmall existing hole in the diaphragm whichresulted in strangulation. Case III. C. W. Age thirty-one. In March,191O. while in France, the patient had alobar pneumonia in the left lower followed and was drained for twomonths, after which healing occurred. Thepatient arrived on this side in June, when aradiograph (Fig. 6) was taken to determinethe lung condition before discharge. Itshowed the stomach fluid le\-el and gas. Fig. 6. Case III. diaphragm, and that it had entered thethoracic cavity through a small opening inthe posterior portion 4 cm. from the esopha-geal opening. The stomach, in good condi-tion, as far as could be seen, was freed fromadhesions and returned to the abdominalcavity. Gangrene set in and the patient diedten days later. The cause of the hole in the diaphragm inthis case could have been due to tearing ofadhesions or to injury by shell evidence had been seen of a hernia at theother hospitals where this man had been a Fig. 7. Case III. Inibble in the left chest up to the level ofthe fourth rib anteriorly. The barium mealshowed an hour-glass stomach, the fundusbeing above the diaphragm and the pyloricend below. The constriction was due to therelatively small size of the diaphragmaticopening in comparison to the size of thestomach. The stomach was empty at theend of two hours. A barium enema sho
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