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To the Editor.–I have just read the excellent article in the September issue of the Archives of Surgery entitled "The Excluded Small Bowel Segment" by John Harmann, MD, and John W. Braasch, MD. We have been extremely interested in jejunoileal bypass and have had a modest experience with the operation. I was indeed struck by the invited editorial comments by E. R. Woodward, MD, when he stated that he did not think it was necessary to close mesenteric defects if they were large. When we were performing jejunoileal bypass several years ago and anastomosing the distal excluded end of the small intestine to the sigmoid colon, a large potential mesenteric trap was created that we always meticulously closed with interrupted silk sutures. On three occasions, we have had this large mesenteric trap reopened, resulting in acute small bowel obstruction necessitating laparotomy. In later years, we have anastomosed the distal
HERRINGTON JL. Mesenteric Trap. Arch Surg. 1977;112(1):98. doi:10.1001/archsurg.1977.01370010100023
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