0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

RATIONALE OF VAGOTOMY AND PYLOROPLASTY IN MANAGEMENT OF BLEEDING DUODENAL ULCER

Gordon Knight Smith, M.D.; Jack Matthews Farris, M.D.
JAMA. 1958;166(8):878-881. doi:10.1001/jama.1958.02990080022005.
Text Size: A A A
Published online

The fundamental problem in the treatment of peptic ulcer is to correct the abnormal neural and humoral phases of gastric activity. The fact that a given ulcer bleeds does not essentially alter this problem. On the basis of these premises the policy has been adopted, in the surgical treatment of ulcer, of performing vagotomy before pyloroplasty when the procedure is elective but reversing this order when there has been acute hemorrhage; in the latter case gastroduodenotomy is done immediately upon opening the abdomen to permit early visualization and treatment of the bleeder. These conclusions are based especially upon experience with 21 patients who were bleeding severely at the time of the operation or had severe hemorrhages immediately before operation. In this group there has not been a single instance of subsequent bleeding, proved recurrence of ulcer, or death. Three case histories illustrate the complete recovery of patients in whom this policy was followed.

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();