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PubMed1954

Detection of small lesions of the large bowel; barium enema versus double contrast.

Roentgen study with the so-called opaque barium enema with some modifications is superior to double contrast study as the primary means of demonstrating polyps in the colon as well as other lesions. The method described combines fluoroscopy, high kilovoltage radiography, fluoroscopically aimed "spot films" taken with compression, suction and evacuation studies. In this way unsuspected as well as suspected polyps can be demonstrated, particularly if attention is directed to the region where polyps are most likely to be found-namely, the distal third of the large bowel. Double contrast study is quite valuable as a supplement to the modified "single contrast" barium enema, but it has not been sufficiently perfected to replace the modified opaque barium enema as a primary procedure. In many instances a combination of methods will, of course, be required.

Barium↗
PubMed1955

Gastric polyposis.

In a series of 48 cases of gastric polyps, 40 patients had benign lesions while the polyps in the remaining eight cases were malignant. Although the symptomatology in this series was not uniform, only one patient was entirely asymptomatic. Of the eight patients with malignant lesions, three had polyps which could well be described as small, suggesting that size may not be a reliable criterion of benignity even in a single lesion. Laboratory studies indicated that anemia, achlorhydria and occult blood in the stools are frequently associated with gastric polyps. There was no apparent correlation, however, between these phenomena and the benign or malignant nature of the lesions.X-ray examination, performed in every instance, was completely negative in six cases and inconclusive in an additional five. Gastroscopy did not reveal the presence of polyps in three of 15 cases. Malignant change was detected by cytologic examination in one case in which both roentgen and gastroscopic examination were negative. The author believes that in most cases of gastric polyps operative treatment affords the greatest degree of safety. An operative procedure of considerably less extent than total gastric resection often is feasible. However, if true polyps occur where removal can be effected only by total gastric resection, the incidence of malignant change in these lesions would seem to indicate the advisability of such a procedure unless positive contraindicating conditions are present.

Achlorhydria↗