The conservative treatment of peptic ulcer is generally admitted by internists and surgeons to be the proper procedure to follow as long as symptomatic relief can be obtained. The difficulty comes in determining when the patient will not respond further to medical care and must be operated on. It is my experience1 that one need not fear that a gastric ulcer will become malignant; at least, this should not be used as an argument for referring patients for operation, since the mortality due to gastric resection in the hands of experienced surgeons exceeds the incidance of malignant transformation. In the clinic with which I have been associated, patients with gastric ulcer have received conservative treatment for the past five years without malignant degeneration.
There is one true indication for operation, and that is uncontrollable pain, which is rarely due to an uncomplicated ulcer but results when an adjacent viscus
HINTON JW. CHRONIC PANCREATITIS ASSOCIATED WITH PEPTIC ULCER. Arch Surg. 1934;28(3):580–588. doi:10.1001/archsurg.1934.01170150157011
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