Studies in abdominal surgery

Abstract

Great judgement is necessary in the selection of cases suitable for operation. First, one would not 'think of operating', in moribund cases. Second, again in malignant cases as a rule one does not operate unless an early diagnosis is made, when the disease is dis¬ tinctly localized, not having had time' to infiltrate the surrounding tissues,'' asi' for example, early malig¬ nant disease of the bowel where one can excise the mass thoroughly, or in another class of cases where,' not with a view of eradicating the disease, but rather relieving the' symptoms operation is frequently justifi¬ able as for example,- Gastro Jejunostomy in Pyloric Cancer or Inguinal C'olotomy for Rectal Cancer. The existence of Septicaemia negatives operation,' unless by operation you can remove the cause; also does Grave Cardiac,: or Pulmonary or Renal disease. So also does' extreme age of the patient.The co-existence of pregnancy with other abnormal Abdominal conditions frequently confronts the Surgeon, who has to decide whether operation is justifiable or not. If the condition is one that can wait a few months without running any grave risk to the. Mother, such as a small fibroid or small Ovarian Tumour, it may be well to wait and watch the symptoms. Should the ovarian give rise to disturbing symptoms which may probably lead to abortion, operation should at once be undertaken. Frequently urgent cases are met with where a pregnancy is complicated with an ovarian Tumour, with a twisted pedicle or a ruptured Cyst with suppuration of its contents, or inflammation of Vermiform Appendix followed by abscess. In these cases operation is imperative .