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Article
March 18, 1911

DTJODENOJEJUNOSTOMY: FOR THE CURE OF POSTOPERATIVE REGURGITANT VOMITING OF BILE AND PANCREATIC JUICES, FOLLOWING GASTRO-ENTEROSTOMY

Author Affiliations

NORFOLK, VA.

JAMA. 1911;LVI(11):792-793. doi:10.1001/jama.1911.02560110006003

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Abstract

Necessity is the mother of invention, and it was necessity that forced me to "dig up," so to speak, the ascending or terminal portion of the duodenum and "buttonhole" it to the distal portion of the jejunum in the case of a patient operated on six weeks previously for ulcer of the stomach, in which a posterior, no-loop gastro-enterostomy had been performed. The operation, though it relieved the original symptoms entirely, yet by some spur or kink occurring at the anastomosis, caused, about every second day—sometimes oftener—a profuse vomiting of biliary and pancreatic fluids. This vomited material rarely contained any food; and, although great quantities of fluid would be vomited at one time (at least a quart sometimes), it did not accumulate in the stomach, as lavage just before vomiting commenced would often fail to bring any of it away-the water returning clear—when, in less than an hour, bright yellow

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