Skip to main content
SpringerLink
Log in

Trends in diagnosis, etiology and treatment of duodenal ulcer

  • Published:
The American Journal of Digestive Diseases

Summary

In Diagnosis, the “trend” seems to beaway from “hunches,” “snapshot” impressions, or machine made diagnoses andtoward more correct and complete scientific diagnosis; based upon studies of the history, repeated observations and various laboratory analyses, with consideration of the entire person and the environment.

In Etiology, the “trend” seems to beaway from a single cause and more toward many different malfunctions with de-emphasis of the acid factor and more attention given to an intangible anti-ulcer mechanism.

In Treatment the advisability of a differentiation between gastric and duodenal ulcer is being recognized.

In gastric ulcer, the “trend” seems to beaway from non-operative management andtoward more extensive surgical resections.

In duodenal ulcer the “trend” seems to beaway from surgical treatment andtoward non-operative management.

Surgical treatment (when indicated by complications) trendsaway from extensive mutilating resections, andtoward more conservative anatomical and physiologic operations.

Surgery is becoming recognized as but an incident, a most important incident, between pre- and post-operative medical management which must be continued indefinitely.

With favorable results depending upon cooperation between the patient and the physician.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lichtman, A. L.: Malignant lesions of duodenum, a study of 49 cases. Proceed. Staff Mayo Clinic., V. 21, No. 25, Dec. 11, 1946.

  2. Allen, Arthur w.: Differential diagnosis in gastroduodenal ulcer. Nat. Gastro-ent. convention June 7, 1948.

  3. St. John, Swenson and Harvey: Ann. of Surg., Feb. 1944, 119–225.

  4. Riecker, H. H.: Peptic ulcer in identical twins. Amer. Inst. Med., 24,878, May 1946.

  5. Gregg, Allen: The golden gate of medicine.

  6. Roth, J. A. and Ivy, A. C.: Caffeine and peptic ulcer. Gastroenterol. V. 7, No. 5, Nov. 1946.

  7. Kuntz, Albert: The autonomic nervous system. Lea and Febiger, Phila., 1945.

    Google Scholar 

  8. Hallendorf, L. and Lovelace, W. R. H.: Aberrant gastric mucosa and pancreatic tissue in a bleeding Meckel’s diverticulum: report of a case. Proced. Staff Meet. Mayo Clin., V. 122, No. 3, Feb. 1947.

  9. Heuer, George J.: The treatment of peptic ulcer. J. B. Lippencott Co., 1944.

  10. Yasinovskiy, M. A.: Insulin therapy in ulcerative disease. J. A. M. A., Dec. 14, 1946.

  11. Bachrach, Grossman and Ivy: Problems in the etiology of peptic ulcer. The resistance of the gastrointestinal tract to the digestive action of its own secretions. Gastroenterol. V. 6, 563, June 1946.

    Google Scholar 

  12. Babkin, B. P.: Secretory mechanism of the digestive glands. Paul B. Hoeber Inc., 1944.

  13. Taylor, H.: Perforated peptic ulcer treatment without operation. Lancet, London, 2-441–476, Sept. 28, 1946.

    Google Scholar 

  14. Ivy, A. C.: A problem of peptic ulcer. J. A. M. A., V. 132, No. 17, 1053, Dec. 28, 1946.

    Google Scholar 

  15. Sandweiss, D. J.: Anti-ulcer (Anthelone) products in treatment of peptic ulcer. Gastroenterol. V. 6, No. 6, June 1946.

  16. Hubacher: Lancet, Aug. 24, 1946, V. 2, 257–292.

    Google Scholar 

  17. Saltzstein, H. C., Sandweiss, D. J., Hammer, John M., Hill, Edw. J. and Vandenberg, H. J. Jr.: Effect of enterogastrone on Mann-Williamson ulcers in dogs. Arch. Surg. 1947, 55–125.

  18. Raimondi, P. J. and Collen, M. F.: Recurrence rate of symptoms in peptic ulcer patients on conservative medical treatment. Gastroenterol. V. 6, No. 3, 176, March 1946.

    Google Scholar 

  19. Kraup, Niels B.: Results of medical treatment of peptic ulcer. Year Book Abst. Gen. Med., 1946, 631.

  20. Kahrs, and Schrumpf: The results of the medical treatment of peptic ulcer. Review of G. E. Oct. 1947, V. 14, No. 10, 673.

    Google Scholar 

  21. Althausen, T. L.: Medical treatment versus prevention of peptic ulcer. Cal. Med., San Francisco, 67, p. 371, Dec. 1947.

    CAS  Google Scholar 

  22. Lewisohn, Richard: Partial gastrection vs. palliative resection in surgical treatment of duodenal ulcer. San Francisco A. M. A. meeting July 1946.

  23. Mage, S.: Recurrent ulceration following subtotal gastrectomy in treatment of gastro-duodenal ulcer. Ann. Surg. Nov. 1942, V. 116 No. 5, 729.

    Article  PubMed  CAS  Google Scholar 

  24. Kennedy, C. S., Reynolds, R. P. and Cantor, M. O.: Demonstration of operation of sphincter action at true gastric stoma. Amer. Jour. Surg., New York, 74, Dec. 1947, p. 808.

    Article  Google Scholar 

  25. Edkins, J. S.: The chemical mechanism of gastric secretion. Amer. Jour. Physiol. 34: 133, 1906 (St. Bartholomew Hospital).

    Google Scholar 

  26. Connell, F. G.: Peptic ulcer, hydrochloric acid and Edkins’ theory. Amer. Jour. Surg., Aug. 1941, V. 57, No. 2, 255–259.

    Article  Google Scholar 

  27. Uvnas, Borje: The part played by the pyloric region in the cephalic phase of gastric secretion. 1942, Acta. Physiol. Scand. Suppl. 13.

  28. Schilling, J. A. and Pearse, H. E.: Re-evaluation of the role of the pyloric antrum in marginal peptic ulcers. S. G. and O., Aug. 1948, V. 87, No. 2, p. 225.

    CAS  Google Scholar 

  29. Rodman, W. L.: Pylorectomy and partial gastrectomy or excision of ulcer bearing area in the treatment of gastric ulcer. S. G. and O. V. 20, Jan. 1915, 25–30.

    Google Scholar 

  30. Ivy, A. C.: Histamine and gastric secretion in relation to anti-histamine drugs. Gastroenterol. July 1948, V. 7, No. 1, 134.

    Google Scholar 

  31. Miller, E. M.: Editorial, “Malrotation of the colon.” S. g. and O., Aug. 1948, p. 235.

  32. Ivy, A. C.: The prevention of recurrence of peptic ulcer, an experimental study. Gastroenterol. 3: 433, 1944.

    Google Scholar 

  33. Ingelfinger, F. J.: The late effects of total and subtotal gastrectomy. New Eng. Jour. of Med., 1944, 231.

  34. Custer and Butt: So-called dumping syndrome after subtotal gastrectomy. Ann. Surg., 123–410, March 1946.

  35. Perman, E.: So-called dumping syndrome after gastroenterostomy. Acta Medica Scand., 128–361, 1947.

  36. Lake, Norman C.: Aftermath of gastrectomy. Brit. Med. Jour., Feb. 14, 1948, p. 285.

  37. Fretheim, Bjarne: Post-operative hypoproteinemia after gastrectomies. 1947 Acta. Chir. Scand. Suppl. 130.

  38. Andrus, Lord and Stefko: Effects of pedicle grafts of jejunum in wall of stomach on gastric secretion. Ann. Surg., 188–499, 1943.

  39. Somervell, T. H.: Physiologic gastrectomy. Brit. Jour. of Surg. Oct. 1945, 33-146, 152.

  40. LeVeen, H. H.: The effect of surgical interruption of the gastric blood flow upon gastric secretion and the prevention of experimental peptic ulcer. S. G. and O., Feb. 1948, 164.

  41. Dragstedt, L. R. et al.: Supra diaphragmatic section of vagus nerve in treatment of duodenal and gastric ulcer. Gastroenterol. 3, 450, 1944.

    Google Scholar 

  42. Dragstedt, L. R.: Editorial J. A. M. A., V. 123, No. 3, Jan. 18, 1947.

  43. Alvarez, W. C.: Sixty years of vagotomy. Gastroenterol. 10-3, March 1948, p. 413.

    Google Scholar 

  44. Hollander, F.: Insulin test. Gastroenterol. 7-607, 1946.

  45. Wolf, S. and Wolff, H. G.: Human gastric function. Oxford Univ. Press., 1943.

  46. Berliner et al.: London Lancet. Sept. 1945, 2-325.

  47. Burden, V. G.: Surgery of peptic ulcer in prisons. Review of G. E. March 1948, p. 208.

  48. Cushing, H. C.: Peptic ulcer and the interbrain. S. G. and O. July 1932, 55-1, 34.

  49. Sandweiss, D. J.: Nocturnal gastric secretion in duodenal ulcer. J. A. M. A., Feb. 2, 1946, 130, 58.

    Google Scholar 

  50. Connell, F. G.: Fundusectomy. S. G. and O. Nov. 1929, 696–701.

  51. Connell, F. G.: Fundusectomy, experimental S. G. and O. Dec. 1931, V. 53, 750–752.

    Google Scholar 

  52. Connell, F. G.: Resection of fundus of stomach for for peptic ulcer. Ann. of Surg. Aug. 1932, 200–203.

  53. Connell, F. G.: Peptic ulcer, intractable or recurrent. Trans. West. Surg., 1938, p. 414.

  54. Connell, F. G.: Partial gastrectomy in treatment of peptic ulcer. Surgery, May 1938, V. 3, No. 5, 696–701.

    Google Scholar 

  55. Connell, F. G.: The problem of intractable peptic ulcer. S. G. and O., Sept. 1939, V. 69, 287–290.

    Google Scholar 

  56. Connell, F. G.: Partial fundusectomy (proximal gastrectomy). Review of 24 cases. Ann. Surg., Dec. 1943, V. 118, No. 6, 1000–1004.

    Article  PubMed  CAS  Google Scholar 

  57. Connell, F. G..: Intractable peptic ulcer. Amer. Jour. of Surg., June 1945, V. 68, No. 3, 388–390.

    Article  Google Scholar 

  58. Watson, J. R.: Effect of fundusectomy on the acidity of the gastric and duodenal contents. Arch. Surg., 31, 1–9, 1935.

    CAS  Google Scholar 

  59. Seely, H. and Zollinger, R.: Fundusectomy in treatment of peptic ulcer. S. G. and O., 9, 155–161, 1935.

    Google Scholar 

  60. Fauley, G. B. and Ivy, A. C.: The prevention of post-operative jejunal ulcer by diet, fundusectomy. S. G. and O., 63, 717, Dec. 1936.

    Google Scholar 

  61. Zollinger, Robert: Gastric resection with the removal of the fundus in treatment of duodenal ulcer. Surg. 8, 79, 1940.

    Google Scholar 

  62. Connell, F. G.: Editorial, Review of Gastroenterol. March 1948.

  63. Ivy, A. C., Cummings, G. M. and Grossman, M. I.: An experimental study of the acid factor in ulceration of the gastrointestinal tract in dogs. Gastroenterol. April 1948, V. 10, p. 714.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oshkosh, Wisconsin

    F. Gregory Connell M.D., F.A.C.S.

Authors
  1. F. Gregory Connell M.D., F.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Connell, F.G. Trends in diagnosis, etiology and treatment of duodenal ulcer. A. J. D. D. 16, 55–63 (1949). https://doi.org/10.1007/BF03001878

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03001878

Keywords

Search

Navigation