Tauxe R V, Wright L F, Hirschowitz B I
Ann Surg. 1975 Apr;181(4):455-7. doi: 10.1097/00000658-197504000-00016.
Recurrent gastrojejunal ulceration is reported in three patients with histamine-fast achlorhydria. In none of these patients was extruding suture material responsible for the ulceration. However, all three patients had a history of alcohol abuse, and one abused aspirin as well. These cases demonstrate that achlorhydria does not protect against anastomotic ulceration. It is suggested that surgical manipulation produces an increased susceptibility to mucosal damage, and that it is erroneous to consider all anastomotic ulceration as a continuation or recurrence of acid peptic disease.
三名无胃酸分泌的患者出现复发性胃空肠溃疡。这些患者中没有一例是由缝线材料外露导致溃疡。然而,所有三名患者都有酗酒史,其中一名还滥用阿司匹林。这些病例表明,胃酸缺乏并不能预防吻合口溃疡。提示手术操作会增加黏膜损伤的易感性,并且认为所有吻合口溃疡都是酸相关性疾病的延续或复发是错误的。