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PREOPERATIVE MANAGEMENT OF GASTROJEJUNOCOLIC FISTULA

HOWARD K. GRAY, M.D.; WENDELL S. SHARPE, M.D.
Arch Surg. 1941;43(5):850-857. doi:10.1001/archsurg.1941.01210170117009.
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The immediate mortality rate after surgical intervention in the treatment of well developed gastrocolic fistula is disturbingly high, and yet the prognosis for the disease if treated by medical means alone is exceedingly poor. Nearly all patients treated medically die of progressive inanition, avitaminosis or intercurrent infection. Verbrugge1 reported a series of 20 cases in which 5 patients died after operation; the mortality rate was thus 25 per cent. Loewy2 collected reports of 63 cases; the operative mortality rate in this group was 27 per cent. Allen3 reported 8 cases with 2 deaths; Lahey and Swinton4 reported an immediate mortality rate of 63 per cent in 8 cases and Rife5 a mortality rate of 20 per cent in 14 cases. A high mortality rate seems to accompany any type of operation performed in one stage, regardless of the technic employed or the quality of the

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