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December 1959

The Problem of Gastric Ulcer

Author Affiliations


Department of Medicine, University of Chicago.

AMA Arch Intern Med. 1959;104(6):995-1020. doi:10.1001/archinte.1959.00270120151019

Introduction  There are two principal attitudes in the management of gastric ulcer. The prevailing surgical opinion is that all gastric ulcers should be removed promptly.1-3 The opposing view, held by numerous physicians and some surgeons, is that gastric ulcer can be dealt with individually: Many patients respond to medical management and others require resection.4-6 The purpose of this paper is to examine the problem, on the basis of evidence in the literature and our clinical experience, in relation to four major issues. These are (a) differentiation of benign and malignant gastric ulcer, (b) the alleged hazard of neoplasia, (c) improvement of the survival rate of gastric cancer by the routine resection of gastric ulcer, and (d) the advantages and limitations of medical and surgical treatment.

General Observations  Gastric ulcer resembles duodenal ulcer in clinical manifestations, course, and in response to treatment.7-9 The pain mechanism, acid irritation of