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June 1969

Reversed Jejunal Segments and Gastric Hypersecretion

Author Affiliations

Des Moines, Iowa
From the Department of Surgery and Surgical Research, Veterans Administration Hospital, Des Moines, Iowa.

Arch Surg. 1969;98(6):713-715. doi:10.1001/archsurg.1969.01340120061007

It is now a well established fact that gastric hypersecretion follows massive intestinal resection.1 The cause for this hypersecretion of acid is unknown at present but may well be due to the absence of normal intestinal inhibitors of gastric secretion.2

The clinical use of reversed intestinal segments has rapidly evolved since 1951 when J. H. Hammer demonstrated that dogs could survive with reversal of the entire duodenum.3 Up to that time the conclusions of F. P. Mall and William Halsted4 in 1896 that reversed intestinal segments ultimately caused death in experimental animals through acute or chronic obstruction had remained unchallenged in the literature. In 1962, L. D. Gibson5 applied Hammer's suggestion6 clinically by reversing a 7.5-cm jejunal segment in a patient who had had a massive intestinal resection. The result was very encouraging and established the use of short reversed intestinal segments in people following

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