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LLOYD M. NYHUS, MD
Chicago

Arch Surg. 1984;119(9):1100.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—The premise that humans are prone to abuse the lining of the stomach and duodenum by the inhalation or ingestion of harmful substances is correct. The concept that a cause-and-effect relationship between this abuse and the failure of certain therapeutic (both medical and surgical) approaches to the treatment of these ulcers is less clear.

Let us assume that a given population of patients with duodenal ulcers are treated by simple gastroenterostomy. During the following decade approximately 35% of these patients will manifest an anastomotic ulceration. According to Dr Peterson, many of these patients have suffered from recurrent ulcer disease because of failure to modify their smoking and/or dietary habits. If this hypothesis were valid, I would expect that the next operative approach for the new anastomotic ulceration would be equally unsuccessful. Unless there is an underlying hormonal cause for the disease, eg, Zollinger-Ellison syndrome, the addition of a . . . [Full Text PDF of this Article]

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