The Roentgen diagnosis of gall-stones by improved methods / by Lewis Gregory Cole, M.D., New York and Arial W. George, M.D., Boston.

  • Cole, Lewis Gregory, 1874-1954
Date:
1915
Catalogue details

Licence: In copyright

Credit: The Roentgen diagnosis of gall-stones by improved methods / by Lewis Gregory Cole, M.D., New York and Arial W. George, M.D., Boston. Source: Wellcome Collection.

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    It is a well recognized fact that gall-stones are found in 10% of all adult cases submitted to post-mortem examination, and as we were able to detect them in 5% of the cases in a routine gastro-intestinal examination, we therefore con¬ cluded that we could find them in about one-half of the cases where they were present. Pfahler estimated that he could detect gall¬ stones in 74% of the cases, which according to him, was 24% more than could be obtained by other Roentgenologists. His percentage was based on 29 cases operated on for gall-stones, in 27 of which stones were found. He had reported findings in twenty of these, but had been unable to detect them in seven where they existed, and in two cases he had reported probable stones wherein no stones were found,—a record of nine erroneous diag¬ noses. Therefore, what Pfahler really reported was 31% of erroneous diagnosis, rather than a per¬ centage of accuracy. When stones are detected by Roentgen meth¬ ods, an operation for their removal is almost universally assured, and unless there are errors in interpretation, the stones are found. But if no stones are found through these methods, the operation is not so likely to be performed, and of this case one has no knowledge of whether or not stones are present. Therefore such a meth¬ od of estimating the percentage is not accurate. A series of cases might be examined, however, in the manner employed by Brewer and Cole,3 in gastro-duodenal lesion, viz: If by using all other methods combined, the surgeon determines that gall-stones are present, he will operate for them regardless of the Roentgen findings. The Roentgenologist makes his examination, making