Original communication| Volume 17, ISSUE 5, P742-749, May 1945

Removal of the vagus innervation of the stomach in gastroduodenal ulcer

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      Supradiaphragmatic division of the vagus nerves has been performed in thirteen patients with duodenal ulcer, in one patient with gastric ulcer, and in one with a gastrojejunal ulcer. The patient with gastric ulcer has been apparently cured of his disease as judged by the disappearance of symptoms and by x-ray and gastroscopic evidence. All but one of the patients with duodenal ulcer have been greatly improved or cured, although three patients have required gastroenterostomy because of persistence of obstructive symptoms. The patient with the gastrojejunal ulcer, although improved, has been continued on medical management. The excessive continuous night secretion of gastric juice has been markedly reduced by the vagus section thus providing additional and perhaps conclusive evidence that this abnormality is neurogenic in origin. The striking improvement in these patients is in harmony with the view that gastroduodenal ulcer is a psychosomatic disease, and that the central nervous system affects the stomach via the vagi, probably chiefly through greatly augmenting the secretion of gastric juice.
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