By Clifford F. Hawkins (Auth.)
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7 Simple gastric ulcer on the lesser curve showing radiating folds of mucosa, so typical of benignity. after medical treatment, when the surrounding inflammation will have subsided. Immediate laparotomy will be considered best where there is a definite risk of malignancy, or if the duration of symptoms warrants surgery, whether the ulcer is benign or not. When it is desirable to avoid surgery, the patient should be put to bed on medical treatment and a 46 Diseases of the alimentary tract further X-ray carried out after one month.
The stomach juice can digest meat and even living tissues without digesting its own mucosal lining. This remarkable protective mechanism fails at once after death and immediate fixation with formalin is necessary if it is intended to study the histology. During life, erosions may occur and heal quickly in spite of the presence of acid; an example of this is the erosion produced by peroral gastric biopsy, the histology of which is similar to that of the acute ulcer. Dragstedt (1961) discusses the controlled secretion of gastric juice in the normal.
The anaemia responds to iron such as ferrous sulphate 300 mg. s. Most patients with hiatus hernia, especially when symptoms persist and the sliding type is present, will require surgery. The purpose of the operation is to reduce the hernia and reconstitute the hiatus so as to prevent any hiatal incompetance (Allison, 1951). A modification of this was described by Collis, Kelly, and Wiley (1954), the purpose of which is to increase the acute angle between the oesophagus and stomach which, from anatomical studies, appears to be the most important factor in preventing reflux.
Diseases of the Alimentary Tract by Clifford F. Hawkins (Auth.)