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June 1956

The Role of the Antrum in Surgery for Duodenal Ulcer

Author Affiliations

Los Angeles
From the Department of Surgery, University of California Medical Center.; John and Mary R. Markle Scholar in Medical Science (Dr. Woodward).

AMA Arch Surg. 1956;72(6):1003-1008. doi:10.1001/archsurg.1956.01270240115016

It is generally thought that benign peptic ulcer of the gastrointestinal tract occurs when there is a relative excess of acid gastric juice over the neutralizing and buffering mechanisms present. In most patients with duodenal ulcer this situation obtains because of hypersecretion of acid gastric juice of nervous origin.1 This hyperstimulation is transmitted from the central nervous system to the stomach by way of the vagus nerves; hence, vagotomy abolishes this pathologic mechanism and allows healing of these lesions.

The gastrointestinal tract, however, is not selective and will succumb to the corrosive action of gastric juice from whatever origin. Thus, in experimental animals the administration of histamine in yellow wax (beeswax) will regularly produce peptic ulceration.2 In dogs the transplantation of the gastric antrum into the colon results in hyperfunction of the antral "gastrin" mechanism.3 Peptic ulcers appear in a large percentage of such animals.4