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Volvulus of the cecum complicating labor
MC
QLINN
:
INCIDENCE
OF
CANCER
OF
lj39
UTERTJS
women under observation. The campaign was not successful, uot that an increasing number of women failed to report for examination but beca,use we failed to recognize the earliest signs of the disease. It is frequently stated that cancer of the cervix is a symptomless disease until it is far advanced and hemorrhage and discharge result. For many years we have been sold on the idea that these two are the cardinal symptoms. So fixed has been this idea that we have failed to study the possibility of other symptoms preceding these classic ones. When we note the extent of the lesion after the first bleeding brought the patient for examination, it is hard to conceive of a Iesiou of such extent and character not producing symptoms. Extensive clinical observation is necessary to discover, if possible, some early characteristic symptom complex : it may be of a local or general character. In the routine examination of cases, we must develop new methods for the early diagnosis of cancer, as our present methods are ina.dequate. Biopsy’ studies are of little value except in cases which are definitely cancer and which, in the majority of ca.ses, can be diagnosed clinically. There are too many positive and negabive errors in the early cases. The difficulty is that there is not a definite histologic picture that will determine a precancerous lesion or a transitional stage! if such lesions exist. If the biopsy is definitely positive or definitely negative, histologic studies are of real value. Lately, much work has been done on early diagnosis by differential st,ain and by illumination plus magnification. I have not had sufficient experience with either the Schiller test or the colposcope to evaluate them. Every effort should be expended to develop these and other met,hods so tha.t very ea.rly diagnoses can be made. In conclusion I would state that with our present knowledge of cancer, we have no reason to hope for a reduction of the incidence of the disease. On the other hand, we can hope for a great reduction of mortality by educational methods to induce women t,o submit to periodic examinations and the development of methods t,o make earlier diagnoses possible. 1900
HITTEXH~IJSE
Baaden, 1:
Margmet 1119,
SQUARE M.:
Volvulus
of
the
Cecum
CompkGing
Labor,
Brit.
M.
,J.
1934.
An interesting case of volvulus of the cecum complicating labor in a twenty-threeyear-old primipara is described. The patient was considered to be in labor for the first forty-two hours after admission before the complication was suspected. The outstanding symptoms were dyspnea and vomiting. Four hours later an exploratory laparotomy was performed and a twisted, dilated cecum relieved. The author advises laparotomy even during labor or early puerperium whenever an intraabdominal disease is suspected. F. 1,. ADAIR AND 8. J. BENENSOHN.
QLINN
:
INCIDENCE
OF
CANCER
OF
lj39
UTERTJS
women under observation. The campaign was not successful, uot that an increasing number of women failed to report for examination but beca,use we failed to recognize the earliest signs of the disease. It is frequently stated that cancer of the cervix is a symptomless disease until it is far advanced and hemorrhage and discharge result. For many years we have been sold on the idea that these two are the cardinal symptoms. So fixed has been this idea that we have failed to study the possibility of other symptoms preceding these classic ones. When we note the extent of the lesion after the first bleeding brought the patient for examination, it is hard to conceive of a Iesiou of such extent and character not producing symptoms. Extensive clinical observation is necessary to discover, if possible, some early characteristic symptom complex : it may be of a local or general character. In the routine examination of cases, we must develop new methods for the early diagnosis of cancer, as our present methods are ina.dequate. Biopsy’ studies are of little value except in cases which are definitely cancer and which, in the majority of ca.ses, can be diagnosed clinically. There are too many positive and negabive errors in the early cases. The difficulty is that there is not a definite histologic picture that will determine a precancerous lesion or a transitional stage! if such lesions exist. If the biopsy is definitely positive or definitely negative, histologic studies are of real value. Lately, much work has been done on early diagnosis by differential st,ain and by illumination plus magnification. I have not had sufficient experience with either the Schiller test or the colposcope to evaluate them. Every effort should be expended to develop these and other met,hods so tha.t very ea.rly diagnoses can be made. In conclusion I would state that with our present knowledge of cancer, we have no reason to hope for a reduction of the incidence of the disease. On the other hand, we can hope for a great reduction of mortality by educational methods to induce women t,o submit to periodic examinations and the development of methods t,o make earlier diagnoses possible. 1900
HITTEXH~IJSE
Baaden, 1:
Margmet 1119,
SQUARE M.:
Volvulus
of
the
Cecum
CompkGing
Labor,
Brit.
M.
,J.
1934.
An interesting case of volvulus of the cecum complicating labor in a twenty-threeyear-old primipara is described. The patient was considered to be in labor for the first forty-two hours after admission before the complication was suspected. The outstanding symptoms were dyspnea and vomiting. Four hours later an exploratory laparotomy was performed and a twisted, dilated cecum relieved. The author advises laparotomy even during labor or early puerperium whenever an intraabdominal disease is suspected. F. 1,. ADAIR AND 8. J. BENENSOHN.