ULTRAHIGH voltage roentgen radiation is frequently used in the management of certain malignant growths. As additional tumor centers are constructed, the use of 1,000,000 volt, and even higher, radiation therapy will increase. Excellent results are being obtained after massive high voltage roentgen irradiation of radiosensitive malignant growths. However, at Walter Reed General Hospital it has been noted that after application of 1,000,000 volt radiation to retroperitoneal nodes in the region of the normal stomach an unusual secondary lesion may occur. Occasionally atypical gastric ulcer develops near the pylorus. The chief symptom is hemorrhage. Perforation has occurred. This condition has been reported elsewhere as a terminal phase of the malignant process. It is, however, usually amenable to surgical treatment.
Similar secondary effects are not new. Gastric ulcer was produced experimentally by Engelstad1 after heavy irradiation of the normal stomach of rabbits. Hueper, de Carvajal-Forero2 and others produced radiation ulcers