Transactions of the American Association of Obstetricians and Gynecologists for the year ... . FlG. 3. loop gastrojejunostomy is the choice of the greater number ofsurgeons who have operated for this condition. This operation is much more readily performed upon the adultthan upon an emaciated infant with a collapsed small intestine 26 332 JOHN W . K E E F E , of small caliber. Intestinal clamps may crush the thin walls ofthe jejimum and cause subsequent sloughing. However, theoperation may be completed without the use of the fine needles and silk should be used on account of theexc
Transactions of the American Association of Obstetricians and Gynecologists for the year ... . FlG. 3. loop gastrojejunostomy is the choice of the greater number ofsurgeons who have operated for this condition. This operation is much more readily performed upon the adultthan upon an emaciated infant with a collapsed small intestine 26 332 JOHN W . K E E F E , of small caliber. Intestinal clamps may crush the thin walls ofthe jejimum and cause subsequent sloughing. However, theoperation may be completed without the use of the fine needles and silk should be used on account of theexceedingly thin walls of the jejunum. Gastrojejunostomy upon a weak, starving infant as a subjectis a decidedly serious operation. It does not directly remedy thestenosis. Bile and pancreatic juice may enter the stomachthrough the stoma and thus interfere with the digestive Fig. 4.—Lines of incision. Wohlbach, six and one-half months after a gastrojejunostomyhad been performed for pyloric stenosis in an infant, madean autopsy and says that the pyloric tumor persisted and ap-peared as at the time of the operation. Richter reports eleven cases of gastrojejunostomy for the cureof pyloric stenosis. Two were cases of pyloric spasm. Onepatient died on the fifth day following operation from a died seven and one-half months after operation fromintestinal obstruction from a kink caused by adhesions. Cannon and Blake in 1905 stated that it was important thatfood be mixed with the secretions poured into the duodenum, PYLORUS IX I X F A X C Y. 333 that these juices are highly effective in digestion and alsoneutralize the acid ch^one. Jejunal ulcers may follow gastrojejunostomy and these ulcersmay be due to the presence of acids in a region where inorganicacid is not normally found. Mo}-nihan mentioned havingknown sixty cases of jejunal ulcer. The
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