A case of gastro-enterostomy for cancer of the pylorus and stomach : good recovery : a new method of suture : with a note as to the patient's condition four months subsequently / by Arthur E. Barker.

  • Arthur E. J. Barker
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A case of gastro-enterostomy for cancer of the pylorus and stomach : good recovery : a new method of suture : with a note as to the patient's condition four months subsequently / by Arthur E. Barker. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    narrowing pylorus, but can pass easily through the new opening, and so, perhaps, that ulceration of the surface of the growth, which leads to grave complications in many cases, may be staved off. As there is no interference here with the processes of digestion, the secretions of the liver and pancreas mixing as before with the food from the stomach, that slow process of starvation, accompanied by distension of the stomach and frequent vomiting, is pre- vented, which often renders these cases so painful and distressing to witness ; the more so because, in many cases, the process is often very slow. Finally, I think it is fair to hope that not only does this operation diminish suffering, but it may also materially prolong life by sustaining the vital powers. But, as remarked above, it is too soon to pronounce upon the procedure definitely; we must suspend our judgment for a time. In the meanwhile, one thing maybe most decidedly deprecated, namely, undertaking such a measure in utterly desperate cases where the patient is in extremis and unfit for any prolonged operation of any kind. It is now more than a month since the operation,* and still the patient continues well. She has suffered a little from constipation on one occasion, but has been relieved by enemata, and, to prevent this trouble recurring, is now taking small doses of laxatives. She sits up every day for some hours, after being confined to bed for more than five months. Her pulse is 78, her temperature normal, her bowels acting well, and altogether she is much improved and cheerful. * I have seen the patient to-day, May 4th (exactly four months after operation). She walked into the room looking veiy well, and seemed to have gained flesh since I last saw her two months ago. Beyond some dyspeptic troubles she does not complain. She says that, with the exception of potato, she can take all ordinary diet, but requires confection of senna still to keep her bowels regular. She was rejoiced when I told her she might go out to walk. I could not detect any change in size or shape in the tumour on manual examina- tion of the abdomen. The poor thing was in hopes she might be able to return to the charge and management of a large dressmaking establishment, but it is need- less to say that, with such a disease, she was over sanguine. Even the hope, however, speaks well for her improvement after operation.