Recurrent Ulceration Following Gastric Resection — A Gastrophotographic and Roentgenographic Study

Summary

A series of 50 cases following Billroth I and II gastric resection with recurrent ulceration diagnosed by gastrophotography was investigated to establish the incidence, size, depth, and location of different types of ulceration. Peptic stomal ulcer was the most common and suture-line ulcer, with protruding suture material, the rarest type of ulcer. The peptic stomal ulcers were concentrated within a small area on the lesser curvature and the jejunal ulcers within the posterior half of the intestine towards the efferent loop. The prospects of diagnosing superficial ulcers by conventional roentgenography were extremely poor and many shallow ulcers were also missed especially following Billroth II resection. After this type of operation the stomal ulcers were most easily overlooked.

Zusammenfassung

In einer Serie von 50 Ulkusrezidiven nach Billroth-I- und -II-Resektion wurde auf Grund des gastrophotographischen Befundes die Inzidenz, Größe, Tiefe und Lokalisation der Ulzerationen ermittelt. Das Anastomosenulkus war am häufigsten, ein Fadenulkus relativ selten nachweisbar. Die Anastomosenulzera häuften sich in einem kleinen Areal im Bereich der kleinen Kurvatur, Ulcera peptica jejuni waren an der Hinterwand der zuführenden Schlinge zu gelegen. Viele flache Ulzera kamen röntgenologisch nicht zur Darstellung, besonders bei B-II-Mägen.

Key-Words

Partially resected stomach - recurrent ulceration - suture-line ulcer - roentgenographic diagnosis - endoscopic diagnosis