Influence of surgery for peptic ulcer on pneumoconiosis and tuberculosis.

Abstract

Phillips, T. J. G. (1970). Brit. J. industr. Med., 27, 245-249. Influence of surgery for peptic ulcer on pneumoconiosis and tuberculosis. Simple pneumoconiosis in coal miners who have had a partial gastrectomy has often been observed at this Panel to lead to progressive massive fibrosis (PMF). A series comprising 224 men, who had had either a partial gastrectomy, a gastro-enterostomy with or without vagotomy, or a simple closure of a perforated peptic ulcer, was collected over a period of four years. A control series of 220 men who had originally presented with simple pneumoconiosis at least 10 years previously was also studied. Active pulmonary tuberculosis developed in 13 of 106 men (12·2%) following partial gastrectomy compared with 2 of 68 men (2·9%) in the gastro-enterostomy group, 1 of 50 men (2%) in the perforated peptic ulcer group, and 4 of 220 men (1·8%) in the control series. Of those who had had a partial gastrectomy, 48·6% progressed to massive fibrosis subsequently, compared with 16·5% in the gastro-enterostomy group, 22% in the perforated peptic ulcer group, and 37·9% in the control series. Possible reasons for these differences are discussed as well as the current theories of the aetiology of PMF. In view of the increased incidence of tuberculosis and possibly of massive fibrosis in those men who have had a partial gastrectomy in this series, it is recommended that this operation should be avoided in the treatment of peptic ulcer in coal miners with pneumoconiosis.