Congenital causes of duodenal ulcers in adults
R. G. Naylor and G. L. Juler
In seven cases of congenital anomalies in adults, duodenal obstruction and
peptic ulcer disease developed. There were two cases of congenital duodenal
web, two of hypertrophic pyloric stenosis, two of annular pancreas, and one
of a preduodenal portal vein. The diagnosis is seldom made preoperatively.
In the four patients who had preoperative gastric analysis, the acid
secretions were increased. Those patients who underwent endoscopy had
changes consistent with hypertrophic secretory gastrophy and duodenitis. We
believe that treatment should be directed toward relief of the duodenal
obstruction and the reduction of basal acid secretion by truncal vagotomy
in all such cases.
