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July 1, 1922


JAMA. 1922;79(1):59-60. doi:10.1001/jama.1922.02640010063032

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To the Editor:  —In The Journal, June 10, 1922, p. 1792, Dr. G. K. Dickinson reported three cases of perforating ulcers of the cecum. No very satisfactory explanation of this condition was advanced, although it was suggested that one case was due to "hemorrhagic cecitis" and the others to "a primary inflammation of the adenoid tissue" of the cecum. Emphasis was placed, both in the article and in the discussion, on the possible primary rôle of bacterial infection.After a careful perusal of the three reported case histories, may I suggest that Dr. Dickinson may have been dealing with instances, of acute, subacute or chronic obstruction of the large intestine at some point far distal to the cecum. What the exact cause of the ileus may have been is immaterial, but it is known that colonic obstruction of any kind is not infrequently associated with ulceration and even perforation at

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