March 1942


Author Affiliations

Chief, East Surgical Service, Massachusetts General Hospital, and Lecturer in Surgery, Harvard Medical School BOSTON

Arch Surg. 1942;44(3):501-519. doi:10.1001/archsurg.1942.01210210105007

Although it is now generally conceded that duodenal ulcer is a functional disorder and responds well to conservative measures, complications develop which require surgical intervention. Approximately 80 per cent of the patients with this lesion are taught to live in such a manner that they are comfortable and able to do their usual work. These persons may be successful in keeping completely symptom free if they refrain from worry and strain, eat properly and eliminate the use of tobacco, alcohol and condiments. Infringement of these rules may bring about recurrence or chronicity, which may well produce a situation that must be handled surgically. It is fair to say that a small percentage of these patients get into trouble in spite of rigid care. They are usually the victims of ulceration in an area that gives no warning of activation until massive hemorrhage or perforation takes place. Whether such a painless

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