Traumatic perforation in carcinoma of the oesophagus

✍ Scribed by G. B. Ong; Arthur Van Langenberg

• Publisher: John Wiley and Sons
• Year: 1970
• Tongue: English
• Weight: 472 KB
• Volume: 57
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800570916

✦ Synopsis

mobilized and it is possible that after this dissection the duodenum became stuck to the undersurface of the liver. The repeat barium studies tend to confirm this suspicion. Some reviewers have not found uniformly good results from simple division of the bands (Mahoney, 1946), and others have recommended pyloroplasty (Whitaker, 1937). Mahoney emphasizes that those patients with severe symptoms derived most benefit from surgery whilst those with equivocal symptoms had equivocal results.

We would recommend complete removal of a band with meticulous haemostasis to prevent secondary adhesions. A careful search for other pathology must be made. If doubt exists as to possible intrinsic duodenal or pyloric disease then inspection of the interior of these organs followed by a pyloroplasty would be a reasonable procedure. Pyloroplasty should also be performed if a band has produced a permanent narrowing of the pylorus or duodenum as in Case 13.

Acknowledgements.-We wish to thank Mr. G. W. Duncan for his advice and encouragement in the preparation of this paper, and also Mr. C. G. Scorer and Mr. J. W. Bradley for permission to publish details of patients under their care. We would like to thank Dr. J. Lavertine and Dr. J. Lamb who helped with the post-mortem studies. Miss J. Graham and Mr. E. Stride gave valuable assistance with the illustrations and photographs which we are pleased to acknowledge.