Patients with a variety of minor or major postgastrectomy disturbances are most frequently designated as mild or severe dumpers. Theories regarding causation of such disturbances are most frequently based on a number and variety of manifestations ascribed to the precipitate evacuation of unprepared foodstuffs into the efferent jejunal loop (dumping). A searching review of the case histories of 33 patients personally subjected to corrective operations because of crippling postanastomotic and postgastrectomy side-effects with the analysis of results after surgery affords additional support to my previous contention that malfunctions other than those caused by dumping are rather frequent.* A number of such malfunctions can be either prevented or eventually rectified by definitive surgical techniques.
Issues involved in the causation of postanastomotic and postgastrectomy side-effects may be attributed to one of three separate mechanisms of malfunction: (1) Gastric pouch malfunction; (2) Dumping malfunction (efferent loop syndrome, Wells and Welbourn16); (3) Reflux