Abstract
In this work physiological processes other than the occurrence of peptic ulcer were being studied after jejuno-colostomy. A resulting and unexpected high incidence of peptic ulcer, however, has led to a study of this condition. All operations were performed on healthy adult dogs under morphine-ether anesthesia, using aseptic technique. Through a right paramedian incision the jejunum was isolated and sectioned approximately 25 to 30 cm. distal to the ligament of Treitz. Both ends were inverted. A side-to-side anastomosis was then made between the proximal jejunal stump and the caecum, or ascending colon. At no time during the procedure was the stomach, duodenum or upper abdomen handled or explored, thus eliminating the element of trauma. The abdomen was closed. For 3 days after operation the animals were given intravenous saline only. Fluids and solid food were then given by mouth in gradually increasing amounts, until they were receiving the regular stock diet.
Seven dogs have died at intervals, longer than 8 days after operation. In 6 of these 7 animals, autopsy revealed on gross examination acute to more chronic forms of peptic ulcers. In one dog autopsied 8 1/2 days after operation an acute gastric ulcer, 2×2 mm., with destruction of the mucosa was found 4 cm. proximal to the pylorus. Two other animals, having died 14 and 27 days after operation, showed gastric ulcers in the pre-pyloric region. The first was an acute ulceration of the mucosa with rounded margins, measuring 2×2 mm., and the other was a large ulcer 1×0.6 cm., having indurated and rolled margins and penetrating deeply into the stomach wall. Near this last ulcer was a second small acute ulceration 2×1.5 mm.
Two dogs died of perforated duodenal ulcers, 39 and 53 days respectively after operation.
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