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January 5, 1935


JAMA. 1935;104(1):6-10. doi:10.1001/jama.1935.02760010008002

This paper deals only with the acute perforations that demand immediate operation. It does not concern those cases of perforation of marginal ulcers causing gastrocolic fistulas, chronic abscesses posterior to the stomach, intermittent leakage with blockage to which attention was called by Lund1 in 1905, or even the forme fruste types of perforated ulcers recently described by Singer.2

The deductions reached are largely based on personal experience in the treatment of forty-one such cases. This experience has been greatly influenced, however, by numerous visits to other hospitals, conversation with other surgeons, and a careful review of the literature. Of course it is generally conceded, even by the most radical adherents of the nonsurgically inclined of medical men, that surgery offers the best hope of recovery. Therefore this discussion will be confined to surgical intervention in this condition, as considered under the following three headings:

1. Drainage after closure

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