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ACUTE COMPLETE OBSTRUCTION OF THE DUODENUM FOLLOWING A GASTROJEJUNOSTOMY:  CURE BY DEGASTRO-ENTEROSTOMY

JOHN E. SUMMERS, M.D.
Arch Surg. 1929;19(2):292-300. doi:10.1001/archsurg.1929.01150020125003.
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The clinical fact has long been noted that the immediate seriousness of an acute intestinal obstruction depends on the location of the obstruction. When located in the duodenum, the higher the obstruction is below the opening through which the bile and pancreatic secretions are discharged, the more serious is the toxicity and the earlier the fatality. Numerous experimental occlusions of the duodenum have proved this.1 Rapid fatalities follow obstructions in the small intestine, and the nearer the obstruction is located to the approach to the duodenum, the earlier death occurs. On the other hand, obstructions in the large bowel may exist for a considerable number of days before symptoms threatening life develop. Of course, if the obstructing cause, wherever located, so interferes with the vitality of the bowel that the blood supply is shut off, gangrene and peritonitis hasten the end. In such an instance, bacterial infection is overwhelmingly

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