The angled postero-anterior projection of the stomach (tangenital view) as an attempt at better visualizationof the high transverse stomach

The high transverse stomach is considered the type most difficult to examine, which is most frequentlyencountered in the very obese patient. And so, despite the use of multiple projections, parts of the contour ofthese stomach, particularly in the region of the upper corpus, occasionally elude full visulization. All of theseconsiderations limit diagnostic accuracy. With this problem in mind, the author has utilized a new projection tominimize the amount of overlapping of the various portions of the stomach. This projection has the virture of"opening up" the stomach, so to speak, by projecting the fundus and upper portion of the body (proximal segment)upward and the antrum and lower portion of the body (distal segment) downward, relatively, so that the appearanceis much the same as in the ordinary sthenic individual. In this procedure, the patient is positioned in preciselythe same manner as for the routine postero-anterior projection of the stomach. A 11x14 inch cassette in the Buckytray is pushed upward and the tube is tilted 45 degree toward the head with centering to the middle of thecassette. Occasionally, right anterior oblique projection is used simultaneously. The target-film distance is 56inches. Average technical factors are 84 kv, 150 ma, 1.5 second. Materials include all patients with a hightransverse stomach who visited the Department of Radiology, S.N.U.H from April up to September in 1968. They are33 men and 19 women, all 52. Summary of the results are as following: 1) There have been 6 isolated instances inwhich the projection made possible a diagnosis which was not otherwise apparent either at fluoroscopy or onroutine roentgenographic study. 2) And there have been 5 cases in which it gave considerable anatomical detailconcerning the localization of the lesion and it was useful in confirming an otherwise equivocal diagnosis.