The flexible gastroscope has come into widespread use, and reports attesting to its value in the diagnosis of gastric disease are numerous. In cases of gastric carcinoma it enables the examiner not only to detect the presence of the tumor but to determine its location, character and extent. On the other hand, it is of value in excluding the presence of gastric cancer in certain suspected cases, thus frequently preventing unnecessary operation. In this way Taylor1 believed that he had probably averted an exploratory laparotomy in 25 of 68 suspected cases.
Unfortunately, gastroscopic examination may fail or prove unsatisfactory in some patients with gastric cancer. Obstruction at the cardia may prevent the examiner from introducing the instrument. Necrotic material, blood or barium sulfate may obscure visibility in the presence of pyloric obstruction. Spasm "ahead of the tumor" may occasionally conceal the lesion when located' in the antrum.2 There
SCHIFF L. GASTROSCOPIC DIAGNOSIS OF GASTRIC CANCER. Arch Surg. 1943;46(6):865-870. doi:10.1001/archsurg.1943.01220120074006