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Sept 14, 1963

Jejunal Sensitivity to Acid Peptic Digestion-Reply

Author Affiliations

New Rochelle, N.Y.

JAMA. 1963;185(11):891. doi:10.1001/jama.1963.03060110094034

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I would like to call your attention to an inaccuracy which also appeared on p 118:

"In the literature Beck and Carrell, Jianu, and Heimlich advocate the use of a gastric tube constructed of the greater curvature. This in itself seems to be an excellent solution to the problem since it eliminates two anastomoses necessary with a colon transplant. However, the obvious disadvantages are those of a high incidence of necrosis of this gastric tube inasmuch as it has to rely on its submucosal blood supply for its entire length."

The point emphasized in the three references is that necrosis of the gastric tube does not occur because the tube does not depend on its submucosal blood supply. The gastric tubes, designed to form a permanent gastrostomy, as described by Beck and Carrell and by Jianu, derive an excellent blood supply from the gastroepiploic vessels which accompany the gastric tube.

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