To observe clonic diaphragmatic spasm is in itself sufficiently surprising, but to find as its probable underlying cause a fracture of the xiphoid process is still more so. Comparatively few instances of spasm of the diaphragm are found recorded, and, so far as can be determined, fracture of the xiphoid process is unique.
REPORT OF CASE
H. S., a married Russian-Jewish tailor, aged 48, was admitted, Oct. 10, 1921, with complaints which led to the diagnosis of duodenal ulcer. Roentgen-ray studies confirmed the impression and, October 13, under ether anesthesia, a transsection of the pyloric antrum with posterior gastroenterostomy (Billroth II) was performed. The ulcer was situated on the anterior and superior surfaces of the duodenum, involving the cap along the lesser curvature. Because of the extensive surrounding induration and cicatrization, it was not removed. An appendix, noted by the pathologist to show "obliterative appendicitis," was excised, and the abdominal