Transactions of the Medical Society of the State of North Carolina [serial] . U SURGERY 285. Oh 286 THE MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA The youngest patient was 20; the oldest 68; over half were under were twice as many women as men in the series. As the symptoms would indicate, diagnosis is very difficult and wasmade only twice. A positive X-ray diagnosis was made before my secondoperation. The use of X-ray is a great aid in diagnosis, because of the largeamount of calcium present in these stones. In the presence of shadow inthe region of the pancreas care must be take


Transactions of the Medical Society of the State of North Carolina [serial] . U SURGERY 285. Oh 286 THE MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA The youngest patient was 20; the oldest 68; over half were under were twice as many women as men in the series. As the symptoms would indicate, diagnosis is very difficult and wasmade only twice. A positive X-ray diagnosis was made before my secondoperation. The use of X-ray is a great aid in diagnosis, because of the largeamount of calcium present in these stones. In the presence of shadow inthe region of the pancreas care must be taken to rule out kidney calculi,as was necessary before my second operation. (Figs. 4 and 5). Operative Treatment: The approach to the pancreas (Figs. 1 and 2)may be made by incising the gastrohepatic or gastrocolic omentum, orthe transverse mesocolon. The latter route gives good access to the tailof the gland, but care must be exercised in this procedure not to injurethe middle colic artery. Access to the posterior surface of the gland isobtained by mobilizing the duodenum along the right


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Keywords: ., bookcentury1800, bookdecade1890, booksubject, booksubjectmedicine