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March 1959

When Should Proximal Colostomy Be Performed for Gastrojejunocolic Fistula?

AMA Arch Surg. 1959;78(3):472-479. doi:10.1001/archsurg.1959.04320030116019

Gastrojejunocolic fistula in the majority of cases is a complication of inadequate surgery for peptic ulceration. Its history is the history of peptic ulcer surgery. In 1881 the first anterior gastrojejunostomy was performed by Wolfler. In 1885 the first posterior gastrojejunostomy was done. This was carried out by von Hacker. As soon after this as 1889, the first stomal ulcer was reported by Braun, and by 1902 the succession of complications of recurrent ulcer was complete. In that year Czerny closed the first gastrocolic fistula. Since then this surgical disease has come to be well recognized, and excellent reviews have appeared.1,2

The principles in the management of these cases are now generally agreed upon. They are, namely, to diagnose the fistula early, to close it as soon as the patient is fit, and to prevent its recurrence by adequate surgery designed to reduce the acidity. For patients who are

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