The positive and negative diagnosis of gastric cancer by means of serial roentgenography / by ewis Gregory Cole, M.D., Professor of Röntgenology, Cornell University Medical College, New York.

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

Licence: In copyright

Credit: The positive and negative diagnosis of gastric cancer by means of serial roentgenography / by ewis Gregory Cole, M.D., Professor of Röntgenology, Cornell University Medical College, New York. Source: Wellcome Collection.

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    Small, round, punched out ulcers of the pars pylorica frequently have the rontgenological ap¬ pearance of duodenal ulcers, the pathology of which has been described by Moynihan and Codman. (Figs. 17A and 17B.) In such cases surgery is un¬ doubtedly indicated. Whether the lesion is malig¬ nant or nonmalignant can be positively determined only by microscopical examination of the specimen. Rontgenologically, tumors of the stomach may be grouped into two classes, inoperable and operable, according to their size, location, and state of mobility. Unfortunately many cases come under the first or inoperable group, because the symptoms of incipient cancer are often so mild that the patient does not consult a physician, or if he does seek medical advice, the physician watches the case, per¬ haps carefully, until classical symptoms of cancer appear. The rontgenological findings in nearly all such instances have shown tumors which were be¬ yond the stage for satisfactory removal. Even in advanced cases, the rontgenological examination is of great value. One can determine the location and extent of the tumor, whether a gastroenterostomy is necessary, and if it is necessary, whether enough healthy gastric wall remains to make the operation possible, and whether a posterior gastrointestinal anastomosis is possible, or whether an anterior gas¬ troenterostomy must be resorted to. In the great majority of inoperable cases surgical procedure, particularly exploratory operation, is thus rendered unnecessary, and the patient is saved the incon¬ venience, expense, and suffering of an operation. This in itself would justify a most careful ront- genological examination. Most of the early carcinomas and indurated ulcers considered here have been found in the prac¬ tice of a few of those physicians who have all doubtful cases examined rontgenologically. By such procedure, and only by such procedure, can malignant gastric lesions be detected in their in- cipiency. These few physicians reap the reward for their confidence in rontgenological examination by making use of an early and accurate diagnosis, for which they themselves get the credit, so far as the patient is concerned. A study of a number of cases, classified as above,