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Giant marginal ulcer.

Publication ,  Journal Article
Gowen, GF; Campbell, RE; McFarland, MM; Alman, BA
Published in: Surg Endosc
February 1994

Marginal ulcer is a well-known complication of gastroenterostomy. It occurs in 3% of patients post-Billroth II subtotal gastrectomy; it occurs in less than 1% if truncal vagotomy is included but in up to 30% of patients with gastroenterostomy without vagotomy. These ulcers occur at the anastomosis, but always on the jejunal side, and are known to develop complications of their own--e.g., intractable pain; hemorrhage, obstruction, perforation, and fistula formation. Prior to the advent of upper-GI endoscopy the main method of diagnosis was by history and upper GI series but the accuracy of the upper-Gi series was about 50% or less. Now that upper-GI endoscopy is available, the accuracy of diagnosis is 95% or better. Since truncal vagotomy has been widely adopted as an integral part of gastric surgery--e.g., antrectomy, hemigastrectomy, subtotal gastrectomy, and gastroenterostomy--the incidence of marginal ulcer has declined. The use of cimetidine, ranitidine, famotidine, omeprazole, sucralfate, and antacids has improved the medical management of duodenal ulcer to such a degree that in recent years there is much less need for surgical intervention and thus the incidence of marginal ulcer has declined even more. In addition, the H-2 blockers and omeprazole can be used in patients with marginal ulcer and achieve healing; therefore complications that so frequently required surgical intervention are much less frequent.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

Surg Endosc

DOI

ISSN

0930-2794

Publication Date

February 1994

Volume

8

Issue

2

Start / End Page

107 / 110

Location

Germany

Related Subject Headings

  • Vomiting
  • Surgery
  • Stomach
  • Recurrence
  • Peptic Ulcer
  • Middle Aged
  • Jejunum
  • Jejunal Diseases
  • Humans
  • Gastroenterostomy
 

Citation

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Gowen, G. F., Campbell, R. E., McFarland, M. M., & Alman, B. A. (1994). Giant marginal ulcer. Surg Endosc, 8(2), 107–110. https://doi.org/10.1007/BF00316619
Gowen, G. F., R. E. Campbell, M. M. McFarland, and B. A. Alman. “Giant marginal ulcer.Surg Endosc 8, no. 2 (February 1994): 107–10. https://doi.org/10.1007/BF00316619.
Gowen GF, Campbell RE, McFarland MM, Alman BA. Giant marginal ulcer. Surg Endosc. 1994 Feb;8(2):107–10.
Gowen, G. F., et al. “Giant marginal ulcer.Surg Endosc, vol. 8, no. 2, Feb. 1994, pp. 107–10. Pubmed, doi:10.1007/BF00316619.
Gowen GF, Campbell RE, McFarland MM, Alman BA. Giant marginal ulcer. Surg Endosc. 1994 Feb;8(2):107–110.
Journal cover image

Published In

Surg Endosc

DOI

ISSN

0930-2794

Publication Date

February 1994

Volume

8

Issue

2

Start / End Page

107 / 110

Location

Germany

Related Subject Headings

  • Vomiting
  • Surgery
  • Stomach
  • Recurrence
  • Peptic Ulcer
  • Middle Aged
  • Jejunum
  • Jejunal Diseases
  • Humans
  • Gastroenterostomy