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April 1956

Functional Efferent Stomal Obstruction Following Subtotal Gastric Resection: A Report of Two Cases Demonstrating the Role of Hypersecretion and Hyperacidity

Author Affiliations

Spokane, Wash.
Rockwood Clinic.

AMA Arch Surg. 1956;72(4):719-724. doi:10.1001/archsurg.1956.01270220167022

INTRODUCTION  Efferent stomal obstruction is an occasional complication of subtotal gastric resection, even when the procedure is carefully planned and executed. The forbearance of surgeon and patient is usually severely strained before the situation is resolved, and the post-operative management is a real challenge to good surgical judgment.Since there is no unanimity of opinion with regard to the exact etiology of this complication, we believe that any new observations should be reported. We have observed two cases in which hypersecretion and hyperacidity were present and measures directed toward the suppression of these factors apparently resulted in release of the obstruction.


Case 1 (Fig. 1).  —A man of 50 years had had periodic episodes of burning, gnawing epigastric distress occurring one or two hours after meals and at night, for 12 years prior to his initial examination, in 1949. Roentgenologic examination of the upper gastrointestinal tract revealed

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