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320 eral to the heart borders, plus gas and a fluid level, almost certainly mean herniation of the stomach (fig. 6). In other cases the characteristic loops of bowel may be seen, or homogeneous opacities due to herniated omentum, liver, spleen, or kidney are at times identified. Additional information of value is obtained in doubtful cases by giving the patient a swallow of the opaque barium mixture, which will positively identify the position of the stomach and the small and large bowel. Subphrenic hematoma In traumatic subphrenic hematoma the roentgen examination will show elevation and fixation of the diaphragm on the affected side (fig. 7). The diagnosis depends on an accurate history of the injury, as well as on the x-ray findings. Rupture of the kidney (fig. 8) In suspected traumatic rupture of the kidney, films should be made of the entire urinary tract, the ribs, the spine, and the pelvis. On these one may see fractures of the ribs, spine, or pelvic bones, with displaced fragments in close proximity to the kidneys or bladder. If the kidney is injured, its shadow will be larger than normal, indistinct in outline, or blurred completely. There will also July, 1945 be loss of the psoas muscle outline on the affected side. The intravenous or retrograde pyelogram will show spilling of the opaque media into the kidney substance or into the perirenal spaces. Lacerated spleen (fig. 9) Laceration of the spleen may be evident on plain films of the abdomen within a few hours after the accident. Solis-Cohen and Levine'7) described the typical roentgen changes in patients with lacerated spleens and reported 3 cases proved by operation. The chief roentgen finding is an enlarged splenic shadow which is indistinct in outline or lost entirely as a result of intracapsular splenic or perisplenic hemorrhage. The blood passes along the gastrosplenic ligament in close proximity to the greater curvature of the stomach, and causes irregular nodular indentations of this border of the stomach. The stomach shows more dilatation with gas than is normal, and is displaced downward and to the right. The displacement and deformation are directly proportional to the degree of hemorrhage. Inflammations Most observers have found the roentgen examination to be of great value in the diag- 7. Solis-Cohen. L. and Levine. S.: Roentgen Diagnosis of Lacerated Spleen. Radiology 39:707-710 (Dec.) 1912. NORTH CAROLINA MEDICAL JOURNAL Fig. 8
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1945 |
Identifier | NCHH-17-006 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 6 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-006.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-006 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Description
Fixed Title * | Page 320 (image) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1945 |
Identifier | NCHH-17-006-0332 |
Form General | Periodicals |
Page Type | all; all images; x-ray; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed61945medi_0332.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 6 |
Issue Number | 7 |
Page Number | 320 |
Health Discipline | Medicine |
Full Text | 320 eral to the heart borders, plus gas and a fluid level, almost certainly mean herniation of the stomach (fig. 6). In other cases the characteristic loops of bowel may be seen, or homogeneous opacities due to herniated omentum, liver, spleen, or kidney are at times identified. Additional information of value is obtained in doubtful cases by giving the patient a swallow of the opaque barium mixture, which will positively identify the position of the stomach and the small and large bowel. Subphrenic hematoma In traumatic subphrenic hematoma the roentgen examination will show elevation and fixation of the diaphragm on the affected side (fig. 7). The diagnosis depends on an accurate history of the injury, as well as on the x-ray findings. Rupture of the kidney (fig. 8) In suspected traumatic rupture of the kidney, films should be made of the entire urinary tract, the ribs, the spine, and the pelvis. On these one may see fractures of the ribs, spine, or pelvic bones, with displaced fragments in close proximity to the kidneys or bladder. If the kidney is injured, its shadow will be larger than normal, indistinct in outline, or blurred completely. There will also July, 1945 be loss of the psoas muscle outline on the affected side. The intravenous or retrograde pyelogram will show spilling of the opaque media into the kidney substance or into the perirenal spaces. Lacerated spleen (fig. 9) Laceration of the spleen may be evident on plain films of the abdomen within a few hours after the accident. Solis-Cohen and Levine'7) described the typical roentgen changes in patients with lacerated spleens and reported 3 cases proved by operation. The chief roentgen finding is an enlarged splenic shadow which is indistinct in outline or lost entirely as a result of intracapsular splenic or perisplenic hemorrhage. The blood passes along the gastrosplenic ligament in close proximity to the greater curvature of the stomach, and causes irregular nodular indentations of this border of the stomach. The stomach shows more dilatation with gas than is normal, and is displaced downward and to the right. The displacement and deformation are directly proportional to the degree of hemorrhage. Inflammations Most observers have found the roentgen examination to be of great value in the diag- 7. Solis-Cohen. L. and Levine. S.: Roentgen Diagnosis of Lacerated Spleen. Radiology 39:707-710 (Dec.) 1912. NORTH CAROLINA MEDICAL JOURNAL Fig. 8 |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-006.pdf |
Document Sort | all; nchh-17 |
Article Title | Roentgenological Aids In The Differential Diagnosis Of Acute Abdominal Conditions |
Article Author | J. P. Rousseau; L. M. Morris |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-006 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
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