IT IS always encouraging to read reports that emphasize surgical triumphs, but often knowledge can be gained from an analysis of failures. In this article, six cases are analyzed to find two recurrent, but avoidable, surgical pitfalls.
A review of the literature reveals that competent surgeons with vast experience can be in error after inspection and palpation of the stomach at laparotomy.1,3-11 As this is true, we believe the surgeon, in making a diagnosis of vital importance to the patient, should consider the radiologist's or the gastroscopist's opinion, and not rely solely upon inspection and palpation after an abdominal incision.
Internists are acutely aware of the above problem because of the many patients who continue postoperatively to have their original symptoms and difficulties. The surgeon may believe the condition is functional, the radiologist is equally emphatic that it is organic, the pathologist has no specimen, the internist is left
MILLER RE. Gastric Lesions: Diagnostic Accuracy of Palpation and Inspection at Laparotomy. Arch Surg. 1965;91(3):424–430. doi:10.1001/archsurg.1965.01320150054008
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