In 158 patients with peptic ulcer associated with pyloric obstruction, surgery was performed either for the gastric retention or for other reasons. Eighty-five of these patients were found to have fibrotic stenosis, and of the remaining 73 patients, 43 had penetrating ulcer. The clinical pictures in these patients were analyzed to determine whether the pathological findings might have been predicted. The features usually considered indicative of stenosis proved unreliable. The findings in patients with a penetrating, nonstenotic ulcer were similar to those in patients who had stenosis. The percentage of patients whose retention failed to respond to medical therapy was nearly the same in the group with penetrating ulcer as in the group with stenosis.
Dworken HJ, Roth HP. Pyloric Obstruction Associated with Peptic Ulcer: A Clinicopathological Analysis of 158 Surgically Treated Cases. JAMA. 1962;180(12):1007–1010. doi:10.1001/jama.1962.03050250013003
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