Roentgen examination of the suprarenal glands

The roentgen diagnosis of small expansive lesions of the suprarenal glands commonly presents great difficulties.Because the suprarenals cannot be outlined in routine films, much hope has been pinned on the method of retroperitoneal insufflation of gas, especially in the form proposed by RUIZ RIVAS (1947).The technique has since been described by several authors, and most recently by COCCHI (1957) in an excellent monograph in which he also gives a comprehensive review of the literature.Pneumoretroperitoneum or retroperitoneal pneumography is technically simple to perform, but assessment of the results is not always easy, since the normal appearance of the suprarenals varies and false conclusions may be drawn from adjacent structures.The following observations and conclusions are based on the findings in a series of over 100 cases examined after the presacral insufflation of 1,000 to 1,500 ml of oxygen.No complications occurred.Each suprarenal gland is situated between the corresponding kidney and the diaphragm and is enclosed by a fatty capsule within the renal fascia.This capsule, which consists of fat and connective tissue, is intimately connected to the suprarenal gland.The gland and the fatty capsule often appear as a single structure in the pneumogram, since the gas is ~