0 2 1 2 1 Total . 0 3 3 *Polypi age of 50 the incidence of carcinoma was 2.4%. The incidence of cholelithiasis in the entire series was 86.9%. The incidence of carcinoma in the presence of gallstones was 1.2% of the total series and 2.2% of the series over age 50. The incidence of carcinoma in the absence of gallstones was 2.2% of the total series and 4.3% of the series over age 50. While these percentages are larger than those for carcinoma in the presence of gallstones, there is no significant statistical difference between the incidences with and without stones. Summary Gallbladder carcinoma is not related to the presence of gallstones. The fact that there were fewer polypi than carcinomas offers no support for the concept that gallbladder polypi are premalignant lesions.There is no justification for the prophylactic re-moval of a gallbladder containing stones or polypi for the purpose of preventing malignancy. Addendum As a corollary to the foregoing analysis of surgical material, consecutive autopsies between 1951 and 1959 inclusive were reviewed. In the age group 30-100 years there were 765 patients and 19.1% had gallstones. Of 251 women 28.7% had gallstones, and of 514 men 14.4% had gallstones. In the light of such a high incidence of gallstones in the general population, the practice of cholecystectomy for uncomplicated cholelithiasis is unsound.RADIOLOGICAL and clinical evidence of largebowel obstruction in pancreatitis has been infrequently reported in the literature. Narrowing at the splenic flexure, accompanied by distension of both the large and small bowel, was described in 1957.1 Glenn and Baylin 2 noted spasm in the midtransverse colon among other x-ray features of acute pancreatitis. Australian authors 3,4 have used the term "colon cut-off sign" to describe the finding of gas in the ascending colon up to the hepatic flexure, with absence of gas in the transverse colon.The following case is one in which survey films of the abdomen, repeated barium examinations of the colon, and serum amylase determinations illustrate a temporary obstruction near the hepatic flexure, due to an acute attack of pancreatitis. The lesion at one point was thought to so resemble carcinoma that operation was planned, but fortunately never executed.A 26-year-old white male was first seen on Dec. 12, 1960, with the chief complaint of intermittent episodes of generalized mid-and lower-abdominal pain of approximately 8 years' duration. The pain was agonizing and cramp-like, From the departments of medicine and surgery, New York University School of Medicine.
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