幽門部（pyloric portion）癌性病変のレントゲン診断

X-ray Diagnosis of the Lesion in the Pyloric Portion of the Stomach: especially of the cancerous lesion

はじめに

　幽門部（pyloric portion）とはどこを指すのかという点にかんしては，今までは，常識的に，習慣的にその名が使われてきたきらいがある．それに，小彎，大彎，前壁，後壁と部別な呼び方も使っている．陥凹性病変，隆起性病変の別もあるわけである．この別に従って，それぞれ検査方法が違うはずである．症例について，この部の検査法と検査するとき注意を払わなければならない点をとり上げて考察したい．

　In the light of the definition described in Bockus's Gastroenterology, the authors define “pyloric portion” as the part of the stomach involving angular region and pyloric antrum which man usually describe.

　The authors studied the way to demonstrate the cancer lesion in the pyloric portion and how to avoid the overlapping of the shadows of duodenum and the spine.

　In the text books published in Europe and U. S., no early cancer is described. In the recently published Japanese books, they state on early cancers and the way sufficiently to demonstrate them. It is satisfactory to utilize double contrast method and compression method to demonstrate both advanced and early cancers. In the cases of this series, double contrast and compression methods in PA or RAO projection are good enough to demonstrate the lesion and lead the authors to correct diagnosis.

　RAO projection and anticholinergic agents make the overlapping of the shadow of duodenum avoided. And man should try to get barium in the pyloric portion away with changing the paient's position to have clear demonstration of the mucosal surface of the pyloric portion, that can bring on correct diagnosis.

　To make correct diagnosis of small Type Ⅱc lesion, it is very important to demonstrate the change in findings of “area gastricae” such as encroachment of edge of the area or more clearly described edge of affected area in normal state.