X-irradiation of the stomach has been reported for the treatment of peptic ulcer in well over 1,000 cases.1,2,5,6 The operative findings in the 16% to 27%2 of treatment failures where recurrences or complications required subsequent surgery have not as yet been reported, as most of the cases have been treated by gastroenterologists and radiologists, not surgeons. This is a review of the operative experience at the Denver Veterans Administration Hospital with 5 cases in which surgical intervention followed irradiation treatment of complicated peptic ulcer.
Irradiation of the body and fundus of the stomach with 1,600-2,600 r (depth dose) produces a cellular degeneration in the gastric mucosa after a lag period of approximately 3 weeks.3,7 This degeneration is mainly in the base of the gastric tubules, with loss of parietal and chief cells. Subsequently there is a reduction in the volume and acidity of gastric secretion beginning 2