Abstract
Twenty-six animals were operated upon for the production of jejunal ulcers using a slight modification of the technic of Mann and Williamson 1 for depriving the jejunum of its normal alkalinity.
In each case the duodenum was transected between the pylorus and the ampulla of Vater and both ends inverted with silk. The jejunum was then divided a few inches beyond Treitz's ligament and again both ends inverted. Following this a gastro-enterostomy was performed between the distal end of the jejunum and the stomach and an enteroenterostomy performed between the closed duodenojejunal loop and the upper ileum about 24 inches below the gastroenterostomy, allowing the bile, pancreatic juice and duodenal secretions to be emptied back into the small bowel at this point. These changes were made in the original procedure because it was felt that the nutrition of the animals would be better preserved if the drainage were done higher in the small intestine, thereby eliminating this factor from the ultimate results. Also since a lateral anastomosis has a better blood supply than one made end-to-end, there would be less chance of criticism on this score as a possible source of ulcer formation.
Ten of these animals formed typical chronic ulcers varying in size from 1/2 to 2 1/2 cm. in diameter. The period necessary for the formation of the ulcers varied from 42 to as long as 428 days with the average of 118 days. The ulcers were multiple in 3 cases. They always formed on the wall of the jejunum opposite the gastroenterostomy stoma and never involved the suture material which was of silk throughout, except in one instance, where the edge of a very large perforating ulcer touched it in one spot.
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