The symptoms, treatment and sequelae of non-malignant duodenal ulcer / par D'Arcy Power.

  • Power, D'Arcy, 1855-1941.
Date:
[1906]
Catalogue details

Licence: In copyright

Credit: The symptoms, treatment and sequelae of non-malignant duodenal ulcer / par D'Arcy Power. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    liotis made at Gay’s Hos])ital, and amoiigsl these were seventy cases of ulcer of the duodenum either open or healed. It api)ears, therefore, that duodenal ulcer occurs in 0,4 per cent of persons dying from all causes as against gastric ulcer which is observed either open or cicatrised in about five per cent of all autopsies. It is further worthy of remark that ulcer of the duodenum is three times as frequent in males as in females, whereas gastric rdcer is twice as common in females as in males. It is interesting, loo, to note that of the seventy cases of duodenal ulcer found post mor- tem, nine were fatal by hasmorrhage, eight by perforation and three as the result of cicatrisation either of the bowel or common bile- duct. lliemorrhage or perforation is equally likely to cause death in those affected with duodenal ulceration, but only in about thir- teen per cent of the cases, whilst cicatrisation and constriction to a dangerous extent takes place in about eleven per cent of the cured cases. Situation. Sir Edwin ferry and Dr. Shaw (') state that in 149 cases of duodenal nicer collected from various sources 123 were situated in the first part of the duodenum, 16 were in the second part and only two were in the third part. The ulcers were multi[)le and were scattered throughout the whole length of the duodenum in eight cases. Duodenal ulcers are often associated with chronic gastric ulcers, and in many cases the ulcer is situa- ted so near the pylorus as to make it appear during an operation that the iierforation has taken place in' the stomach. Causes. Nothing is known with certainty as to the causes of ulcer of the duodenum. It is often associated with ulcer of the sto- mach and tlie causes which produce gastric ulcer probably play a part in causing ulcer of the duodenum. The duodeiuim, too, is lia- ble to the same inflammatory conditions as other parts of the ali- mentary canal. Tuberculous and typhoid ulceration are therefore not uncommon. There is no doubt that general septic and ])yte- rnic conditions may be associated with duodenal ulcer and to these causes, perhaps is to he assigned the duodenal ulceration found in a certain proportion of patients who have been burnt especially when there has been much suppuration. The experiments made by Dr. William Hunter(-) point in the same direction, for he showed that the subcutaneous injection of toluene-diamine into dogs was followed {') Loc. cit. (') I’alliological Society'.s Trim.sactioll^, vol. 41, p. 2o5.