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ARTICLE |

THE FACTOR OF SPASM IN THE ETIOLOGY OF PEPTIC ULCERS

M. E. STEINBERG, M.D.; PAUL H. STARR, B.S.
Arch Surg. 1934;29(6):895-906. doi:10.1001/archsurg.1934.01180060002001.
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Exalto1 was the first investigator to develop a technic which regularly produced chronic ulcerations of the jejunum. He severed the stomach immediately above the pyloric valve according to the method of von Eiselsberg. The distal and proximal ends of the stomach were closed. The jejunum was severed distal to the duodenojejunal flexure, and both ends were closed. The distal jejunum was anastomosed to the stomach near its proximal closed end. The duodenum was anastomosed into the jejunum 20 cm. distal to the gastrojejunal anastomosis, according to the method of Roux, or into the colon (fig. 1). Exalto therefore deserves the credit for the originality in implanting the duodenum into the colon and thus completely diverting the alkaline duodenal contents from the gastrojejunal anastomosis.

Exalto performed a typical gastrojejunal anastomosis in seven dogs according to the method of von Eiselsberg without the short-circuiting operation of Roux. He failed to obtain

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