Abstract
NONE methods suggested hitherto for suturing and burying the duodenal stump is able to prevent in every case the formation of a postoperative duodenal fistula. Not infrequently the fistula presents itself after operations in the course of which no technical difficulties arose in dealing with the stump; peritonization is rendered difficult on account of inflammatory, scarring and adhesive processes in the neighborhood of the ulcer. Besides the insufficiency of the secretion accumulating in the stump, there are peristaltic changes directed toward the anastomosis after operation, ischemia due to the occasional ligation of the pyloric and gastroduodenal arteries and diminished resistance of the duodenal wall owing to inflammatory and scarring processes. Among the 96 cases collected by Kittelson 1 fistula was due to a previous operation performed on the gallbladder in 30 and to perforation of the duodenal ulcer in 22, whereas acute appendicitis played a role in 7, traumatic rupture
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
