ROENTGENOLOGIC STUDIES ON THE INTESTINAL CANAL:I. STUDIES ON THE X-RAY FINDINGS OF THE SMALL INTESTINES IN CHRONIC DIARRHEA AND OBSTIPATION

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• To check the changes in the appearance of the loops of the small intestine, serial indirect (6×6cm size) and direct photographies were used.After ingestion of barium test meal, exposures were made every 15 minutes for a period of 1 hour, and then every 30 minutes for 3.5 hours; (that is to say, 4.5 hours after initial ingestion of barium). Fluoroscopic examination was an essential part of the procedure.The results were summarized as follows(A) In 136 cases of chronic diarrhea, which had no abnormal changes in the colon, 39 cases (28.7%) showed normal appearance of the samll intestine. However, in 92 cases (67.6%), roentgen examination revealed abnormalities in the mucosal pattern, the tonicity and the motility of the loops in various degrees.1) In conformity with these abnormal appearance roentgen features were classified into following 6 types: Type I: coarsening of the mucosal folds (7 cases-5.1%), Type II: hypersecretion (16 cases-11.8%), Type III: mixed type—coarsening of the mucosal folds and hypersecretion (85 cases-62.5%), Type IV: hyperkinesis (7 cases-5.1%), Type VI: non pathologics (10 cases-7.4%).Type I, II, and III, (79% in total) were considered as inflammatory changes, and type III, as the most common feature of the enteritis.2) In general, the transit time of the small intestine had a tendency to be accelerated in cases with chronic diarrhea, although it was relatively delayed in a few cases. Transit time comparatively shortened in type III, but prolonged in type IV.3) Emaciation and abdominal pain was mainly associated with the changes of type II and III, while the latter symptom was most frequently encountered in cases with accelerated transit time.(B) In chronic obstipation 44% of 50 cases showed roentgenologically normal appearance of the loops of the small intestine, but cases with I (2 cases-4%), type II (5 cases-10%) and type III (10 cases-20%) were also found, including a few habitual laxative employers.The transit time was normal or slightly delayed in the cases with chronic constipation.(C) A mixture of 150cc of liquid paraffin and 150gms of barium sulphate powder was given to 5 healthy subjects. All of them showed abnormal feature analogous to type II.

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