Studies on Experimental Jejunal Ulcer.

Abstract

In this paper we are concerned with the experimental production of jejunal ulcers by the “duodenal drainage” method described by Mann. This consists of resection of the pylorus, closure of the upper end of the duodenum, section of the jejunum just beyond the ligament of Treitz, anastomosis of the proximal loop of the jejunum to the ileum, and an end-to-end anastomosis of the distal loop to the end of the stomach. The only striking difference between the method used here and that of Mann was that a side-to-side gastroenterostomy stoma was made instead of the end-to-end anastomosis that he used. The duodenal secretions along with bile and pancreatic juice were drained into the ileum or jejunum at varying levels instead of close to the caecum as he described.

In a series of 12 dogs, 2 died in 13 and 25 days from complications without ulcer formation. One animal is alive one year after the operation apparently in good health. Nine animals died and a definite ulcer was found in the jejunum. Of these 7 died from peritonitis following perforation of the ulcer and 2 from incidental infections. The ulcers were located on the mesenteric side of the jejunum opposite the end of the stoma in 6 animals, while in 2 the ulcer was located on the anti-mesenteric side just beyond the stoma. In one animal there were 2 ulcers found located in the 2 positions described. The size of the ulcers varied from a diameter of .7 cm. to an oval shaped one measuring 2.5 × 3.2 cm. The size of the stoma varied from 4.5 cm. to 12 cm. in circumference. The average circumference was 7.42 cm. The shortest duration of life in which an ulcer was found was 32 days.