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December 1949

PSYCHIATRIC ASPECTS OF VAGOTOMY: IV. Phantom Ulcer Pain

Arch NeurPsych. 1949;62(6):728-733. doi:10.1001/archneurpsyc.1949.02310180029004
Abstract

IN THE COURSE of a psychiatric study of patients with peptic ulcer treated by vagotomy1 a syndrome characterized by the persistence of the pain of the ulcer after operation was encountered in a number of cases. Several patients were observed who, in general, responded to vagotomy in the following manner: Immediately after the operation the pain of the ulcer was relieved and the lesion healed, as demonstrated roentgenologically. Then, usually within a few weeks, the preoperative abdominal symptoms returned, and the patient felt it necessary to resume taking milk or antacids, or even to return to the former diet.

This syndrome seems to be one of the clearcut sequelae of vagotomy. Moore,2 for example, in a series of 74 patients, encountered 2 with "ulcer pain" but without a demonstrable ulcer. No satisfactory explanation has as yet been put forward to account for the persistence of symptoms of ulcer

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