Armisted C. Crump, M.D.; George C. Hennig, M.D.; Julius Wolf, M.D.
JAMA. 1954;156(14):1323-1326. doi:10.1001/jama.1954.02950140023009.
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Routine upper gastrointestinal roentgenographic studies often fail to reveal early carcinomas of the fundus of the stomach because of the relative difficulty of examining this region. Roentgenologists' "myopia," as Wangensteen has called it, is in part due to the inaccessibility of this region to palpation. Occasionally the flexible gastroscope will encounter an area of fixed obstruction in the cardia of the stomach when roentgenographic studies have failed to demonstrate any disease. We have encountered similar obstruction to the passage of a wide bore rubber tube with flexible obturator in 13 cases of cancer about the cardia or fundus of the stomach when gastrointestinal roentgenographic studies were considered to be normal. All these patients were referred for gastroscopy because of the persistent suspicion of cancer. Since it is our routine practice to aspirate the stomach with this wide bore rubber tube prior to gastroscopy, the obstruction was first encountered by the


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