Emergency gastrectomy for bleeding duodenal ulcer in a patient with severely impaired respiratory function
✍ Scribed by I. B. Schooling; L. Simon
- Publisher
- John Wiley and Sons
- Year
- 1958
- Tongue
- English
- Weight
- 323 KB
- Volume
- 46
- Category
- Article
- ISSN
- 0007-1323
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✦ Synopsis
vacuoles which were usually arranged in chains or rows lengthwise along the lumen. Normally, as the gut lengthened, these vacuoles opened into the lumen and disappeared, but exceptionally, the coalescence of these vacuoles might form longitudinal channels which could communicate with the main lumen or be independent. Bremer believes that duplications are the result of persistence of these subsidiary channels, which would become lined by columnar epithelium and bounded by basement membrane dividing them from the main bowel ; submucosal layers would appear concurrently with normal intestinal development.
This view adequately explains the occurrence of a common circular muscle, the variability of any communication with the parent bowel, and the elaborate mirroring of the gut which may occur. The fact that these duplications may be lined by gastric mucosa in no way excludes this theory. At the stage when these vacuoles are formed, the small intestine measures from 2 to 2.5 mm. and disproportionate overgrowth of primitive gastric epithelium along a part of the small intestine might well occur.
We wish to thank Professor W. S. Craig for allowing us access to his clinical notes. For the photography we are indebted to Mr.