To the Editor.—I am writing concerning "Vascular Compression of the Duodenum and Peptic Ulcer Disease" (Arch Surg 108:674, 1974).
In my opinion, none of the roentgenograms (Fig 1 through 3) are at all convincing of mechanical obstruction within the duodenum. I would like to know what the interpretation of the Department of Radiology was.
Practically all of the roentgenographic findings given as indicating vascular compression of the duodenum may well be normal.
More attention in the review of the literature should have been given to that opinion that holds that dilated duodenum is indeed common with peptic disease of the stomach and duodenum, and most likely stems from neurogenic reflex. With no trouble at all, some dozen causes of nonobstructive dilation of the duodenum can be given.