To make an early diagnosis of tumorous disease of the pancreas and ampulla is difficult to say the least. Any help, any new idea which improves upon our present inadequacies, is most welcome. The monograph by Jacquement, Liotta, and Mallet-Guy offers us a view of a new and original method which may prove to be quite useful.
Briefly, they describe a method of visualizing the duodenal loop radiographically by first causing the duodenal wall to lose its tone. For this an intramuscular injection of an anticholinergic drug oxyphenonium (Antrenyl), is given after a tube has been passed into the duodenum. A viscous solution of lidocaine (Xylocaine) is placed in the duodenum to anesthetize it, and this is followed by distention with barium sulphate suspension. The flaccid, distended duodenum by more intimately abutting against the pancreatic head indicates abnormality of size and contour of the head with greater sensitivity. Ample description