Forty-one patients with carcinoma of the gullet and oesophagogastric junction have been investigated by means of a new pneumomediastinographic method of pertracheal insufflation. More than 1,600 patients suffering from various pulmonary or mediastinal lesions have undergone this simple time-saving procedure. Pneumomediastinography cannot replace radiography of the gullet or oesophagoscopy in cases of cancer of the oesophagus. Since it reveals valuable details, which remain hidden in conventional radiographs or during oesophagoscopy, it may complement the findings of two traditional methods of investigation. The main advantages of pneumomediastinography in the diagnosis of cancer of the gullet are: it permits accurate assessment of the size and shape of the tumour; in patients submitted to radiotherapy, the local response to this treatment may be determined by changes in the size of the tumour shadow in pneumomediastinal tomograms; it establishes reliably that the tumour does not invade the adjacent organs; it facilitates visualization of some of the enlarged lymph nodes in the mediastinum which are not visible in conventional radiographs or tomograms; and the radiological characteristics of these lymph nodes facilitate an approximate differentiation between inflammatory and metastatic enlargements.
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