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January 13, 1940


JAMA. 1940;114(2):107-112. doi:10.1001/jama.1940.02810020011003

The surgeon has become increasingly concerned with the nutrition of the surgical patient since it has been shown that a variety of lesions complicating operations are the result of nutritional disturbances. Jones, Eaton and White1 and Mecray, Barden, Ravdin and their associates2 have called attention to the hazards resulting from hypoproteinemia in patients subjected to operation. As the serum protein level is reduced in a dog with an intact stomach by diet and plasmapheresis the gastric emptying time of a water-barium meal is prolonged (fig. 1). Hypoproteinemia in man may so accentuate the edema around the stoma of a newly formed gastro-enteric anastomosis as to mimic in every way a technical defect of the anastomosis (figs. 2, 3, 4 and 5). In this condition there occurs also a marked delay in the passage of a bolus through the small intestine.3 The studies of Thompson, Ravdin, Rhoads and

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