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THE RELATIONSHIP OF NONABSORBABLE SUTURE MATERIAL TO JEJUNAL ULCER: AN EXPERIMENTAL STUDY

THE RELATIONSHIP OF NONABSORBABLE SUTURE MATERIAL TO JEJUNAL ULCER: AN EXPERIMENTAL STUDY Abstract When jejunal ulcers1 began to appear as complications of gastroenterostomy, nonabsorbable sutures sometimes were discovered in their bases. This quickly led to the assumption of a cause and effect relationship between the foreign material and the unwelcome sequel. Many papers were written on the subject, but the clinical evidence resolved itself almost exclusively to the association of the ulcer with a thread still retained. Sometimes the suture has been partially cast off but was still adherent in the region of the ulcer, or at other times a strand of thread or a knot was exposed in the base of the ulcer. But on the other hand, the retained suture frequently had no connection with the ulcer; in over one half of the cases the ulcer was away from the suture line.2 The discovery of such a foreign body in the base of a jejunal ulcer was so dramatic References 1. The term jejunal ulcer here and throughout this paper is intended to include both the anastomotic (gastrojejunal) ulcer and the ulcer in the jejunum distinctly separated from the gastro-enterostomy stoma. 2. Hurst, A. F., and Rowlands, R. P.: Jejunal and Gastro-Jejunal Ulcers , Guys Hosp. Rep. 71:319, 1921. 3. Wright, G.: Secondary Jejunal and Gastro-Jejunal Ulceration , Brit. J. Surg. 6:390, 1919.Crossref 4. Mayo, C. H.: Gastric and Duodenal Ulcers , Ann. Surg. 73:328, 1921.Crossref 5. Paterson, H. J.: Jejunal and Gastro-Jejunal Ulcer: Its Etiology and Prevention , Internat. J. Surg. 33:138, 1920. 6. Delore, X., and Convert, P.: L'Ulcére peptique du jéjunum consécutif à la gastroentérostomie (à propos de cinq observations) , Rev. de chir. 58:26, 1920. 7. Eusterman, G. B.: A Clinical Study of Eighty-Three Gastro-Jejunal Ulcers: Diagnosis Verified at Operation , Minnesota Med. 3:517, 1920. 8. Walton, A. J.: Gastro-Jejunal Ulcer , Lancet 2:800, 1925.Crossref 9. Mayo, C. H.: A Consideration of Gastric and Duodenal Ulcer , Proc. Roy. Soc. Med. (sect. surg.) 18:73, 1925. 10. Mayo, W. J.: Ulcer of the Stomach and Duodenum with Special Reference to the End Results , Ann. Surg. 54:313, 1911.Crossref 11. Moynihan, B.: Disappointments After Gastro-Enterostomy , Brit. M. J. 2:33, 1919.Crossref 12. Mayo, W. J.: Chronic Ulcers of the Stomach and Duodenum , Ann. Surg. 60:220, 1914.Crossref 13. Von Haberer, H.: Die Bedeutung des Pylorus für das Zustandekommen des postoperativen Jejunalulcus , Arch. f. klin. Chir. 117:50, 1921. 14. Lewisohn, R.: Gastro-Jejunal and Jejunal Ulcers: Report of Twenty-One Cases , J. A. M. A. 77:442 ( (Aug. 6) ) 1921.Crossref 15. Lewisohn, R.: The Frequency of Gastro-Jejunal Ulcers , Surg. Gynec. Obst. 40:70, 1925 16. Walton (footnote 7, second reference). 17. Strauss, A. A.; Block, L., and Friedman, J. G.: Gastro-Jejunal Ulcer: Medical and Surgical Considerations , J. A. M. A. 90:181 ( (Jan. 21) ) 1928.Crossref 18. Bland-Sutton, J.: Ulcers New and Old: Jejunal for Duodenal Ulcers , Brit. M. J. 1:272, 1916.Crossref 19. Mann, F. C., and Williamson, C. S.: The Experimental Production of Peptic Ulcer , Ann. Surg. 77:409, 1923.Crossref 20. Morton, C. B.: Observations on Peptic Ulcer , Ann. Surg. 85:207, 1927.Crossref 21. Dott, N. M., and Lim, R. K. S.: Experimental Jejunal Ulcer , Quart. J. Exper. Physiol. , (Suppl. 109) , 1923. 22. Watts, S. H.: A Case of Peptic Ulcer in the Jejunum of a Dog Following Gastroenterostomy, with a Review of the Cases Reported in Man , Bull. Johns Hopkins Hosp. 14:191, 1903. 23. Dragstedt, L. R., and Vaughn, A. M.: Gastric Ulcer Studies , Arch. Surg. 8:791 ( (May) ) 1924.Crossref 24. Gronnerud, P.: The Etiological Relations of the Sequelae to Gastro-Enterostomy , Ann. Surg. 66:177, 1917.Crossref 25. Montgomery, A. H.: Gastro-Jejunal Ulcer: An Experimental Study , Arch. Surg. 6:136 ( (Jan.) ) 1923.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

THE RELATIONSHIP OF NONABSORBABLE SUTURE MATERIAL TO JEJUNAL ULCER: AN EXPERIMENTAL STUDY

Archives of Surgery , Volume 18 (4) – Apr 1, 1929

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Publisher
American Medical Association
Copyright
Copyright © 1929 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1929.01140130682044
Publisher site
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Abstract

Abstract When jejunal ulcers1 began to appear as complications of gastroenterostomy, nonabsorbable sutures sometimes were discovered in their bases. This quickly led to the assumption of a cause and effect relationship between the foreign material and the unwelcome sequel. Many papers were written on the subject, but the clinical evidence resolved itself almost exclusively to the association of the ulcer with a thread still retained. Sometimes the suture has been partially cast off but was still adherent in the region of the ulcer, or at other times a strand of thread or a knot was exposed in the base of the ulcer. But on the other hand, the retained suture frequently had no connection with the ulcer; in over one half of the cases the ulcer was away from the suture line.2 The discovery of such a foreign body in the base of a jejunal ulcer was so dramatic References 1. The term jejunal ulcer here and throughout this paper is intended to include both the anastomotic (gastrojejunal) ulcer and the ulcer in the jejunum distinctly separated from the gastro-enterostomy stoma. 2. Hurst, A. F., and Rowlands, R. P.: Jejunal and Gastro-Jejunal Ulcers , Guys Hosp. Rep. 71:319, 1921. 3. Wright, G.: Secondary Jejunal and Gastro-Jejunal Ulceration , Brit. J. Surg. 6:390, 1919.Crossref 4. Mayo, C. H.: Gastric and Duodenal Ulcers , Ann. Surg. 73:328, 1921.Crossref 5. Paterson, H. J.: Jejunal and Gastro-Jejunal Ulcer: Its Etiology and Prevention , Internat. J. Surg. 33:138, 1920. 6. Delore, X., and Convert, P.: L'Ulcére peptique du jéjunum consécutif à la gastroentérostomie (à propos de cinq observations) , Rev. de chir. 58:26, 1920. 7. Eusterman, G. B.: A Clinical Study of Eighty-Three Gastro-Jejunal Ulcers: Diagnosis Verified at Operation , Minnesota Med. 3:517, 1920. 8. Walton, A. J.: Gastro-Jejunal Ulcer , Lancet 2:800, 1925.Crossref 9. Mayo, C. H.: A Consideration of Gastric and Duodenal Ulcer , Proc. Roy. Soc. Med. (sect. surg.) 18:73, 1925. 10. Mayo, W. J.: Ulcer of the Stomach and Duodenum with Special Reference to the End Results , Ann. Surg. 54:313, 1911.Crossref 11. Moynihan, B.: Disappointments After Gastro-Enterostomy , Brit. M. J. 2:33, 1919.Crossref 12. Mayo, W. J.: Chronic Ulcers of the Stomach and Duodenum , Ann. Surg. 60:220, 1914.Crossref 13. Von Haberer, H.: Die Bedeutung des Pylorus für das Zustandekommen des postoperativen Jejunalulcus , Arch. f. klin. Chir. 117:50, 1921. 14. Lewisohn, R.: Gastro-Jejunal and Jejunal Ulcers: Report of Twenty-One Cases , J. A. M. A. 77:442 ( (Aug. 6) ) 1921.Crossref 15. Lewisohn, R.: The Frequency of Gastro-Jejunal Ulcers , Surg. Gynec. Obst. 40:70, 1925 16. Walton (footnote 7, second reference). 17. Strauss, A. A.; Block, L., and Friedman, J. G.: Gastro-Jejunal Ulcer: Medical and Surgical Considerations , J. A. M. A. 90:181 ( (Jan. 21) ) 1928.Crossref 18. Bland-Sutton, J.: Ulcers New and Old: Jejunal for Duodenal Ulcers , Brit. M. J. 1:272, 1916.Crossref 19. Mann, F. C., and Williamson, C. S.: The Experimental Production of Peptic Ulcer , Ann. Surg. 77:409, 1923.Crossref 20. Morton, C. B.: Observations on Peptic Ulcer , Ann. Surg. 85:207, 1927.Crossref 21. Dott, N. M., and Lim, R. K. S.: Experimental Jejunal Ulcer , Quart. J. Exper. Physiol. , (Suppl. 109) , 1923. 22. Watts, S. H.: A Case of Peptic Ulcer in the Jejunum of a Dog Following Gastroenterostomy, with a Review of the Cases Reported in Man , Bull. Johns Hopkins Hosp. 14:191, 1903. 23. Dragstedt, L. R., and Vaughn, A. M.: Gastric Ulcer Studies , Arch. Surg. 8:791 ( (May) ) 1924.Crossref 24. Gronnerud, P.: The Etiological Relations of the Sequelae to Gastro-Enterostomy , Ann. Surg. 66:177, 1917.Crossref 25. Montgomery, A. H.: Gastro-Jejunal Ulcer: An Experimental Study , Arch. Surg. 6:136 ( (Jan.) ) 1923.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1929

References