PERFORATION OF JEJUNAL ULCER INTO THE FREE ABDOMINAL CAVITY

Jejunal (including gastrojejunal) ulcers of peptic origin are conceded to be relatively serious as compared with similar lesions in the stomach and duodenum. The seriousness of a jejunal ulcer can be attributed chiefly to the proclivity of the defect to extend rapidly beyond the wall of the intestine. This tendency is due to the thinness of the jejunum and to the inherent susceptibility to peptic corrosion of this portion of the digestive tract. The complications which develop as a result of the extension of an ulcer beyond the serous coat of the jejunum are of two principal types, penetrative and perforative. Penetration occurs when an adjacent structure becomes attached to the base of the ulcer before actual rupture occurs. Often there develops a granulomatous mass of considerable size simulating a neoplasm. Perforation generally occurs into the free peritoneal cavity or into a neighboring hollow viscus. Occasionally, however, the entire thickness