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July 1948

EFFECT OF EXCLUSIVE PARENTERAL FEEDING ON THE CLOSURE OF A PANCREATIC FISTULA: Study Made After Duodenopancreatic Resection for Carcinoma of the Ampulla of Vater

Author Affiliations

From the Department of Surgery, Washington University Medical School and Barnes Hospital.

Arch Surg. 1948;57(1):104-112. doi:10.1001/archsurg.1948.01240020107009

THIS REPORT describes observations made on a patient with a complete pancreatic fistula. It is the first time, we believe, that the influence of exclusive parenteral feeding in such a case has been reported. Changes in pancreatic secretion were of special interest; of therapeutic importance was the spontaneous permanent closure of the fistula during the regimen.

REPORT OF A CASE  M. B., a 67 year old white man, entered the St. Louis City Hospital in May, 1947, with a history of jaundice of three weeks' duration. He had lost 50 pounds 22.7 Kg. of weight over a period of six months and had had a profound anorexia for this same period. His urine was dark, and he had light-colored stools. He had no pain whatever. He had had no chills or fever. The past history and the family history were noncontributory.Physical exxamination revealed a poorly nourished white man appearing