Abstract
Gastric mucosa has 1 a strong natural immunity against corrosion by gastric juice, and wounds made artificially in it tend to heal readily. Mann, 2 , 5 Dragstedt and Vaughan, 3 Morton, 4 and others have shown that when other tissues such as kidney, spleen, mucosas of various portions of the intestinal tract with an intact blood supply are implanted into defects made in the stomach wall, they tend to remain sound and healthy without erosion or ulceration, even though exposed to the normal stomach contents. Mann and Williamson, 6 , 7 after draining the duodenal juices into the lower ileum, anastomosed the upper jejunum to the stomach, ulcers formed in the jejunum. These ulcers were interpreted as due to the corrosive action of acid gastric contents on a sensitive intestinal mucosa now unprotected by the alkaline duodenal juices, plus the “motor drive” mechanical effect of the stomach contents being ejected forcibly against the spot on the intestinal wall where the ulcer was supposed to form. Ivy and Pauley 8 point out, the emaciation which most of these animals undergo must not be overlooked. Aschner and Karelitz 9 have summarized some 33 cases of ulcer of the ileum associated with Meckel's diverticulum containing heterotopic mucosa of gastric type. These ulcers were interpreted as due to gastric juice secreted by this heterotopic mucosa.
We attempted to duplicate this situation experimentally by making a small pawlow pouch, and causing it to empty into an isolated loop of lower ileum, whose other end communicated with the lower ileum just above the ileocaecal valve. In this way the possibility of mechanical action in possible ulcer formation was avoided.
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