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KMID : 0371319720140020083
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Journal of the Korean Surgical Society
1972 Volume.14 No. 2 p.83 ~ p.89
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Marginal Ulcer with Massive Hemorrhage
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Abstract
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Marginal or stomal ulcer after the first operative treatment of peptic ulcer disease reflects the failure
of surgical correction of the ulcer diathesis.
Aside from the extragastric source sucj as a pancreatic islet-celltumor or other endocrine disorders,
the causes of the marginal ulcer may result either from physiologically ill conceived older operative
procedures such as simple gastroenterostomy or Devine exclusion operation, or from incomplete or
inadequate technical conduct of such operations as partial gastrectomy, vagotomy with drainage proce
dures and vagotomy with antral resection.
Two cases of marginal ulcer with massive hemorrhage after duodenal ulcer surgery were presented
and recent literature reviewed.
The first cases had vagotomy and gastrojejunostomy for duodenal ulcer with pyloric stenosis at a
private clinic 7 months prior to admission. On exploring the abdomen, there were two marginal ulcers,
one just below the stoma and the other with one blood vessel in its base at the efferent jejunal loop.
Hemigastrectomy with excision of the gastrojejunostomy was done and new gastrojejunostomy made.
The second case had a simplt gastroenterostomy for duodenal ulver with stenosis because of liver
cirrhosis at a private clinic 3 years prior to admission. On exploring the abdomen, there was one mar
ginal ulcer with one blood vessel in its base at the efferent jejunal loop.
Subtotal gastrectomy with excision of the gastrojejunostomy was done and new gastrojejunostomy
made.
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