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June 14, 1924


Author Affiliations

Lieutenant-Commander, Medical Corps, U. S. Navy ST. CROIX, V. I.

JAMA. 1924;82(24):1926-1927. doi:10.1001/jama.1924.02650500022010

What we expect to find and the condition that exists inside the abdomen may be decidedly different. This is the more striking after previous operation in the peritoneal cavity. In the normal, healthy state there are the stomach, the more solid viscera and the small intestines, intricately coiled and folded, gliding softly and maintaining their integrity. But disease or trauma distorts the arrangement, and leaves adhesions to alter function.

A not uncommon result of gastro-enterostomy is the fixation of the transverse colon in the vicinity of the anastomosis. Should the cause of the original ulceration not be removed, new ulcers may occur in spite of the drainage of the gastric contents provided for by the operation. The outcome of such an ulcer perforating the walls of the jejunum and the colon at the site of fixation is a gastrojejunocolic fistula.

Early recognition and intervention offer fair chances for recovery. Delay