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November 13, 1937


Author Affiliations


From the Medical Service of the Peter Bent Brigham Hospital.

JAMA. 1937;109(20):1629-1631. doi:10.1001/jama.1937.92780460004010c

Recently we observed an instance of portal thrombophlebitis and multiple liver abscess following invasion of the vein by a perforating duodenal ulcer. This fistulous sequel is one of many that may result from perforation of a peptic ulcer. The review by Monroe1 indicates that, depending on the location of the lesion in the stomach or proximal intestine, any contiguous viscus may be invaded. From the stomach, morbid connection has been found leading to the spleen, transverse colon, duodenum and, through the diaphragm, to the lung, the pericardium and even the heart; from the duodenum to the pancreas, pancreatic duct, gallbladder, biliary duct and portal vein. The last eventuality is mentioned in textbooks,2 but few actual cases have been reported either in detail or by brief account. It is also more unusual to find reference to pylephlebitis originating in duodenal rather than in gastric ulcer, although this distinction is of little importance in