Dilatation  of  the  stomach  (gastrectasia)  may  be  acute  or  chronic.  Acute
dilatation  of  the  stomach  is  a  sudden  paralytic  distention  of  uncertain  origin.
It  may  follow  the  ingestion  of  enormous  fjuantitics  of  food  or  drink,  and  occa-
sionally arises  after  laparotomy,  particularly  in  the  upper  abdomen.  The
symptoms  are  [>ain,  vomiting,  and  distention  of  the  abdomen,  the  last  causing
interference  with  the  heart  and  lungs  and  in  many  cases  leading  to  death.
The  treatment  is  gastric  lavage  and  the  general  measures  for  shock.
Chronic  dilatation  is  usually  the  result  of  pyloric  stenosis,  but  may  be
caused  also  by  overeating,  chronic  gastritis,  and  general  malnutrition  (atonic
diialation).  The  symptoms  are  dyspe[isia,  often  hunger  and  thirst,  and  vomit-
ing at  intcn-als  of  large  quantities  of  decomposing  food,  some  of  which  has  lain
in  the  stomach  for  several  days.  The  patient  emaciates,  passes  small  quantities
of  urine,  is  constipated,  an<l  may  have  attacks  of  tclanv.  da-mvcvaMvOTv  o\ "^t
stomach  contents  rr\eals  iJic  s.irrin.i  vcnlricviU  a.t\(\  vuMv^  o\!s\t\  ViVk.c\E.\\!v.\  '<fe.t

J4


53°


ABDOUEN.
amount  of  hydrochloric  and  lactic  acids  will  depend  upon  the  cause  of  the
dilatation.  The  stomach  is  prolapsed  to  below  the  umbilicus,  and  is  often  visi-
ble through  the  abdominal  wall.  Peristalsis  passing  from  left  to  right  likewise
may  be  seen  at  times.  On  palpation  the  cushion-Uke  resistance  of  the  stomach
may  be  felt  and  often  a  splashing  sound  elicited.  In  some  cases  a  tumor  may
be  detected  in  the  pyloric  region.  The  sire  of  the  stomach  is  determined  by
percussion,  after  filling  the  stomach  with  air  or  water,  or  by  measuring  the


KlG.  J45-


Kio.  i»6.
FiC.  34?.
Fic.  j«.
I'lcs.  J4S  to  .uo.  — I  Moynihtn.)


Flo.  ojo.
