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November 7, 1925


Author Affiliations


JAMA. 1925;85(19):1462-1465. doi:10.1001/jama.1925.02670190022005

That the peristaltic wave in the gastro-intestinal tract is normally in an analward direction is, I believe, axiomatic, with the exception of the proximal portion of the colon. Here antiperistalsis has been so commonly observed that it is certainly accepted as the usual, if not the normal, procedure.

A perusal of the literature on antiperistalsis in the duodenum offers so many disappointments that one approaches this subject with some trepidation. It is, of course, a matter of common knowledge that the peristaltic wave reverses itself in obstructive lesions at or near the duodenojejunal junction, whether the lesion is intrinsic or extrensic to the intestine. Cole and Holzknecht, independently of each other, experimentally produced this in 1910 by mechanical blocking of the lumen. Joseph and Metzler,1 in rabbits, and Wheelon and Thomas,2 in dogs, studied the motility of the duodenum by means of balloons anchored in the duodenum and