File:Interstate medical journal (1917) (14781322654).jpg

Identifier: interstatemedica2419unse (find matches)
Title: Interstate medical journal
Year: 1917 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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ent63 percent. ( Group VI.63 percent Simple deformity of the cap, withslight stenosis or without stenosisand with a normal or slightlyactive gastric peristalsis, whichempties the stomach in six hours,and without a deep crater orsecondary gastric involvement. 30 INTERSTATE MEDICAL JOURNAL The first group, consisting of 8 percent of the cases, deals withthose cases in which the induration and cicatricial contraction haveresulted in such a deformity or obliteration of the cap, with amarked degree of stenosis of the pylorus, that the compensatinggastric peristalsis has failed to evacuate the stomach in six or evenin ten or twelve hours. These are referred to as having brokencompensation. In this group of cases it is evident that surgical relief is absolutelynecessary, otherwise the patients die of inanition. Therefore wehave no cases treated medically to compare with these eight caseswhich we will consider in this group. Of the eight cases, only two will be used for illustrative purposes.
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Fig. 1.—Illustrates group 1. Sur- Fig. 2.—Illustrates group 1. Sur-gically treated. gically treated. Case I. (Fig. 1.) Clinical history: Indigestion for five years. Nausea and vomiting after alarge meal. No history of hemorrhage. Roentgen diagnosis: Obstructive postpyloric ulcer. Surgical findings: Obstructive ulcer found and palliative operation done.Subsequent history: Marked gain in weight and disappearance of all symp-toms. Patient reports that he is able to eat everything. Case II. (Fig. 2.) Clinical history: Three years previously symptoms began and consisted ofattacks of pain and vomiting at intervals of several days. Weight loss of40 pounds. A history of two previous operations, one for appendicitis. Roentgen diagnosis: Postpyloric stenosis, causing a large gastric dilatation.Diagnosis of an ulcer on the anterior surface of the cap, with adhesions. Surgical findings: A mass involving the cap, pyloric valve and extreme INTERSTATE MEDICAL JOURNAL 31 pyloric end of the stomac

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