Chester M. Jones

Transdiaphragmatic Resection of the Vagus Nerves for Peptic Ulcer

DURING the last fifty years, a variety of surgical maneuvers have been developed for the treatment of cases of peptic ulcer ∥ that may be broadly termed as intractable to therapy but are otherwise uncomplicated. According to Allen,1 approximately 20 of every 100 patients suffering from peptic ulcer who present themselves to a physician do poorly under ordinary nonoperative methods of treatment. A sizable fraction of this group develop hemorrhage, perforation or cicatricial obstruction, obviously requiring surgical intervention. The remainder — estimated by Allen and Welch2 as 10 per cent — stand as medical failures or as intermittently sick patients. .xa0.xa0.

The reversibility of Whipple's disease. Report of a case, with comments on the influence of corticosteroid therapy.

AS an unusual cause of malabsorption, Whipples uf disease (intestinal lipodystrophy) has excited the interest of clinicians because of the diffuse manifestations, the progressive clinical course and speculation over possible pathogenesis. The typical clinical picture is that of a debilitating disease manifested by abdominal pain, steatorrhea, gastrointestinal bleeding, lymphadenopathy, arthritis and pigmentation that, without treatment, usually leads to death within twelve months of the diagnosis. Diagnosis is based on the histologic demonstration of an accumulation of macrophages filled with cytoplasmic inclusions that give a positive periodic acidSchiff (PAS) reaction. These macrophages are present in the small-bowel mucosa, peripheral lymph nodes .xa0.xa0.