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September 22, 1956


JAMA. 1956;162(4):425. doi:10.1001/jama.1956.02970210165026

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To the Editor:—  The paper of Evans and Poker entitled "Newer Roentgenographic Techniques in the Diagnosis of Retroperitoneal Tumors" (J. A. M. A.161:1128 [July 21] 1956) perpetuates a number of fallacies regarding retroperitoneal pneumography requiring clarification. 1. The presacral route of injecting gases into the retroperitoneal space has not abolished the danger of gas embolism. Although only two deaths and one severe nonfatal reaction from use of this technique have been reported thus far, we have learned of 24 additional fatalities and 33 additional severe nonfatal reactions. This information was obtained in response to a questionnaire sent to more than 1,700 urologists throughout the United States. 2. Oxygen is no safer than air as far as the danger of gas embolism is concerned. Five of the 24 deaths we have gathered occurred in cases in which oxygen was used, certainly not proportionately less than those due to air,

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