Medicine: Stomach Wrinkles

Wrinkles (rugae) cover the entire lining of the stomach. They all run parallel to the long axis of the stomach from the cardiac end where fresh food comes in to the pyloric end where digested food goes out into the intestines. Pathologists notice that every ulcer or cancer of the stomach always distorts the neat parallelism of the wrinkles. But they notice it only after the patient is dead and the autopsist has done his work. If x-ray pictures had shown the irregular wrinkles, the doctor might have saved the patient before it was too late.

Ordinary x-ray pictures, taken after the patient has eaten a paste of barium sulphate, show only the outline of the stomach. A method of outlining all the rugae occurred to a few roentgenologists. notably to Dr. Aubrey Otis Hampton, 34, a sharp-nosed Texan who went to Boston to practice medicine. Last week he explained the method to other fellows of the American College of Surgeons (see p. 35) who crowded his lecture in Boston.

He gives his patient a sip of barium sulphate in thick cream and a moment later has him rub his belly. This kneads the stomach and spreads the barium cream evenly into all the wrinkles, leaving their ridges bare and transparent to x-rays. The roentgenogram appears striped. Every deflected stripe indicates potentially serious trouble. Dr. Hampton now is trying to adapt the same method to showing the haustra, or tucks, of the colon which often churn up disease.

Most precious use so far for the Hampton technique is to discern an ulcer at the pyloric end of the stomach. That is the stomach’s most active spot. Ulcers there, declares Director George Hoyt Bigelow of Massachusetts General Hospital, invariably turn into cancers. As with all cancers, if the surgeon can recognize them in their early stages, he can destroy them before they destroy his patient. Director Bigelow told the surgeons in Boston last week that his staff surgeons, by operating quickly, have prevented cancers in practically every pyloric ulcer Dr. Hampton has photographed for them.