US2602444A - Ureter block for use in pyelograms - Google Patents

Description

July 8, 9 D. R. STANFORD URETER BLOCK FOR USE IN PYELOGRAMS 3 Sheets-Sheet 1 Filed Oct. 2, 1950 FIG STANFORD Ihwemor DAVID R.

attorneys July 8, 1952 D. R. STANFORD 5 2 URETER BLOCK FOR USE IN PYELOGRAMS Filed Oct. 2, 1950 5 Sheets-Sheet 2 FIG DAVID R. STANFORD Snvcntor Gttornegs y 3, 1952 D. R. STANFORD URETER BLOCK FOR USE IN PYELOGRAMS .5 Sheets-Sheet 5 Filed Oct. 2, 1950 vao R. STNF Gttomegs.

Patented July 8, 1952 UNITEDLLSTATES PAT ENT.zOF-FICE, I p r 2,602,444 v I v URETER BLOCK FOR UsE N PYELOG-RAMS -DavidR. fitanford, Renton, Wash. zlpplicationflctober 2, 1950, Serial No. 187,956

My invention concerns compression m ansrtr blocking the ureters during the taking of Dyelograms; and, moreparticularly concerns theuse ,offa block of radiolucent material, such as balsa wood, adapted to compress the ureters in the sacroiliac region to; dam 'X-ray opaque materials inthe urinary system.

Examination of the ureters is now frequently and successfully accomplished by' intravenous pyelog'r'aphy, thus producing a satisfactory study without subjecting the patient to the discomfort of a retrograde examination. In this method, X-ra'y opaque material is' intravenously injected while the patient recline's on 'a table belowthe X-ray machine. The opaque material tends to move too rapidly through the urinary system to sufficiently delimitithe ureters unless some means is usedto impede the flow. A common method of blocking the'ureters to retain the opaque material is todep'ress an air-inflated rubber ball, such asa football bladder, into the patients body, to compress the ureters in the sacroiliac region. such'ball or bladder, however,'is anunsatisfactory member to use for such blocking action.

Onefault is that the bladderis' made ,of rubber which is partially x-rayiopaque and the skiagram is obscured: in the area of theblocking member. Another fault is that the bladder is not designed for such use" and, when it accomplishes'thefunction of blocking the ureters it does so'in spite of its shape. The bladder compressesa Wide area instead of ,just the points where the ureters'pas's the sacroiliac region, and

the patient suffers additional unnecessary'discomfort and the ureters may'n'ot be sufficiently blocked. The upper portion of the rubber ball or bladder is not adapted for applying the compressingforce, as by use of a band secured atone end to a side "of the table and having tightening means'at the other end secured to the other side of the table.

The objects of my invention, therefore, include: to provide compression means for blocking the ureters during the taking of pyelograms; to florm said compression means of substantially radiolucentmaterials' so the skiagram is not obsoured in the area of the compression means; to provide an improved design for the compression means to accomplish the function of blocking the ureters in the sacroiliac region; to minimize the discomfort of the patient during .the taking of "pyelograms and to provide more efficient means for accomplishing the examination; and to adapt the blocking means to facilitate "the-application of compressive force on said means.

Briefly, the foregoing objects are accomplished in my; invention by the following structure: A blocking member is constructed from some substantially radiolucent material such as balsa wood. The top portion of the block is substantially rectangular to be positioned with its longitudinal axis running crossways of the human body. The block has two depending portions, the depending portions joining at their upper portions and dividing at their lower portions. The lower portionshave horizontal cross sections substantially in the form of rectangles with rounded corners. Each lower portion has convex sides and a bottom which is slightly convexly curved transversely of the human body. "The bottoms of thelower portions have their centers spaced apart one from another substantially the distance that the average ureters are spaced apart in the sacroiliac region. When the depending portions are depressed, they are in positionto 'efiectively block the ureters with a minimum ofdi'sturbance of the organs. The topportionis flat and of substantial width, forming'a suitable surface for the applying of pressure on the block, as by use of a band secured atone side of the table on which the patient reclines and having tightening means at the other end secured to the other side ofthe table.

My invention and the manner'in which these and other objects are accomplished,will be best understood from the following detailed description of a'specific embodiment of my invention, when read with reference to the accompanying drawingsin which:

Figure 1 is a perspective view looking upwards atthe bottom portion'o'f a specific embodiment of my ureter compressing block;

Figure2'is a front view of the block;

Figure 3 is an end view of the same;

Figure 4 is a perspective view .of'a' patient reclining on a table with saidblock'in .position'to be urged downward by a compression band; and

Figure 5 is a plan view, in fragmentary form, showing the urinary system and certain bones of the skeleton, with the positioning of ureter compressing block indicated in dotted lines.

My ureter compression block should be constructed from some substantially radiolucent material. Balsa wood has proven to be quite satisfactory .for this purpose, and is shown in the drawings. Any substantiallyX-ray opaque material obscures the covered .areaof the ureters in the skiagram. Usually two .X- -rays are taken while the X-ray opaque material is contained in the kidneys and ureters, one while the uretersare blocked and one shortly after the ureters are freed to show the lower part of the ureters while they still contain X-ray opaque material. In order to clearly show the ureters in these two X- rays, it'is important'to'be able to show'all of that portion of the ureters to the point of compressionin the first X-ray. If an X-ray opaque compression device is used, the portion of the ureters adjacent the point of damming is obscured. When a balsa block is used, the covered area of the ureters appears quite satisfactorily on the skiagram.

Block 10 is composed essentially of top portion l2 and depending. portions [4 and 16. Top portion I2 is substantially rectangular with rounded corners, preferably, even though other shapes could be used. Top surface [8 is flat and with this construction a good surface is provided for application of force, as by compression band 20, shown in Figure 4. Ends 2i are rounded facilitating movement of the block along band 20 for adjustment of the same. Band 20 has considerable width affording stability, and top portion I2 is of a width to accommodate band 20. Depending portions l4 and I6 do not need such width to perform their compressing function and top portion [2 overhangs them on all sides.

Depending portions 14 and I6 are joined at their upper portions, as at 22, for strength and convenience of manufacture, and separate, forming two lower portions 24 and 26. Lower portions 24 and 26 are substantially rectangular with rounded corners in horizontal cross-section and have convex sides. Depending portions l4 and I6 could be formed somewhat differently, the most important feature being the providing of two bottom surfaces 30 and 32. Having thebottom surfaces divided provides for maximum compression of the ureters and minimum disturbance of other parts of the body. Bottom surfaces 30 and 32 are of substantial size to accommodate the various positions the ureters may assume in different persons. Bottom surfaces 30 and 32 are slightly convexly curved transversely of the body but are substantially straight longitudinally of the body.

Referring to Figure 4, the patient is shown reclining on table 40. Band 20 issecured at one end and the other end is secured by adjustable means for tightening the band. The adjustable means include a shaft supported by brackets 42 and handle 44 is connected to the shaft to rotate the same. Some means for adjustably securing the shaft should be provided, as by a ratchet and pawl assembly. Normally an X-ray is taken before block I is positioned, for orientation. Then block ll] is positioned as shown in Figure 4 and the X-ray opaque material is usually intravenously injected before band 20 is tightened. As band 20 is tightened, depending portions [2 and M are depressed until bottom surfaces 30 and 32 compress the ureters. Block may be shifted as band is tightened,'in which case it may be rocked back into position by hand. One X-ra is usually taken while the ureters are blocked and one is taken shortly after compression is relieved. Y

In Figure 5 the positioning of bottom surfaces and 32 is indicated in dotted lines at 50. Pressure is over the sacrum 52 and the sacroiliac area 54. Occasionally part'ofthe pressure is onthe fifth lumbar vertebra 56. One way to locate bottom surfaces'30 and 32 is to position their ends toward kidneys 58 about two fingers below the crest 60 of ilium 62. Ureters 64 may Vary in spacing in different patients from six to nine and onehalf centimeters so'the centers of bottom surfaces 30 and 32 should be spaced approximately the distance of the average spacing of ureters and they should be wide enough to apply direct pressure throughout the normal range of spacing of ureters. The first X-ray after injection of X-ray opaque material obtains a view of kidneys 58 and upper portion 66 of ureters 64. After pressure is removed, a view of lower portion 68 of ureters His obtained leading to bladder 10.

It 'will be apparent from the above description that I have conceived of improved radiolucent compression means for blocking the ureters during the taking of pyelograms, in which the blocking is efficiently accomplished and with a minimum of discomfort to the patient. While I have described a specific embodiment of my invention, I do not wish to be understood as limiting myself to that embodiment, but wish to claim all modifications within the fair scope of my invention.

I claim:

1. Compression means for blocking the ureters during the taking of an X-ray of the urinary system, comprising: a balsa wood block having the characteristic of being substantially. radiolucent, said block to be positioned on the human body above the sacroiliac and depressed to dam the ureters in that region, said block having a top portion which is substantially rectangular and elongated and having two depending portions, .said depending portions being joined at their upper portions and dividing at their lower portions, said lower portions having horizontal cross sections substantially in the form of rectangles with rounded corners throughout most of their extensions, said lower portions .being spaced apart one from another in a direction which is longitudinal of said top portion, each lower portion having convex sides and a bottom which is slightly convexly curved in a direction which is longitudinal of said top portion, said bottoms of said lower portions having their centers spaced apart one from another substantially the distance that the average ureters are spaced apart in the sacroiliac region.

2. Compression means for blocking the ureters during the taking of a pyelogram, comprising: a balsa wood block having the characteristic of being substantially radiolucent; said block having a top portion and two depending portions extending downward a considerable distance; said depending portions having their lower portions slightly rounded and having the crests of said lower portions spaced apart one from another substantially the distance that the average ure ters are spaced apart in the sacroiliac region.

3. C'ompressionmeans for blocking the ureters.

during the taking of an X-ray-of the urinary system, comprising: a block having the characteristic of being substantially radiolucent, said block having a top portion and two depending portions extending downward a considerable distance, said depending portions having their lower surfaces spaced apart one from another such a distance that the ureters in the sacroiliac region are compressed upon depression of said block into that region.

DAVID R; STANFORD.

' REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Zaras Apr. 3, 1951-

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