Negative diagnosis of surgical lesions of the stomach and cap / by Lewis Gregory Cole, M.D. Professor of Roentgenology in Cornell University Medical College.

  • Cole, Lewis Gregory, 1874-1954
Date:
1914
Catalogue details

Licence: In copyright

Credit: Negative diagnosis of surgical lesions of the stomach and cap / by Lewis Gregory Cole, M.D. Professor of Roentgenology in Cornell University Medical College. Source: Wellcome Collection.

    3/94 (page 1)
    STOMACH AND CAP By LEWIS GREGORY COLE, M. D. Professor of Roentgenology in Cornell University Medical College Reprinted from the November 191b issue of The American Journal of Roentgenology The value of a positive diagnosis of can¬ cer or ulcer of the stomach or cap is directly in proportion to the accuracy of the negative diagnosis. A diagnostic method which en¬ ables one to state with a reasonable degree of certainty that a patient has or has not a gastric cancer or ulcer, has or has not an ulcer of the cap, occupies a unique position. At the last annual meetings of both the Gas- tro-enterological Society and the Medical Section of the American Medical Associa¬ tion it was asserted repeatedly that the early diagnosis of gastric cancer is impossible. To this statement I take exception emphatically, referring you to numerous communications* which show the accuracy of the positive diagnosis of ulcer and cancer of the stomach and cap, and especially to a report on twenty-seven consecutive cases examined by serial Roentgenography and operated upon by Dr. Brewer.** Each of the twenty-seven cases presented sufficiently definite clinical symptoms of a lesion of the stomach or cap to justify surgical exploration. In eleven cases, or forty per cent of the number in¬ vestigated, examination by serial Roentgen¬ ography resulted in a negative diagnosis of *Arch. of the Roent. Ray, Dec., 1911, Apr., 1912, Oct., 1912. Journal of the Am. Med. Assn., Nov. 30, 1912. N. V Med. Jour., Feb. 14, 1914, Vol. xcic, No. 7, p. 305. Zeit. f. klin. Med., Berl., 79 . H. 5 u. 6, 1914. The Lancet, hond., May 2, 1914, No. 4731, Vol. clxxxvi, p. 1230. **Annals of Surgery (forthcoming issue). ulcer or cancer—or of any surgical lesion of the stomach or cap. Nor was a surgical lesion of the stomach or cap found at oper¬ ation in any one of these cases. A negative diagnosis of gastric carcinoma and indur¬ ated ulcer of the stomach and cap has been made in five hundred and sixty-six cases out of the whole number of gastro-intestinal cases examined to date. Thirty-three of these cases presented sufficiently severe symptoms to justify surgical exploration; and it is upon the results in these thirty-three cases, operated upon by twenty-three differ¬ ent surgeons, that the present communica¬ tion is based. The negative diagnosis of gastric cancer and ulcer of the stomach or cap was made in each case solely on the Roentgenographic findings, and in not a single instance was a lesion of the stomach or cap demonstrated by surgical exploration. In many cases a lesion at some other point in the gastro-intestinal tract was demon¬ strated Roentgenologically and proven by surgical procedure. As limited space pro¬ hibits a full consideration of each of the thirty-three cases, only eight characteristic cases will be described in detail and illus¬ trated. Of the other twenty-five cases only the clinical diagnosis, Roentgenologic diag¬ nosis and surgical findings will be given. In thirty-two out of the thirty-three cases the l