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Intestinal absorption and jejunal morphology in duodenal ulcer patients

With particular reference to the influence of subtotal gastric resection

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Summary and conclusions

1. Impaired intestinal absorption manifested by a subnormal carotene-loading test may be demonstrated in some patients with duodenal ulcer who have not undergone gastric resection.

2. Subnormal carotene-loading tests may be found in some duodenal ulcer patients during the first few weeks after subtotal gastrectomy. In some cases, however, the abnormality revealed by this test tends to regress and the tests revert in time to normal.

3. No consistent correlation could be demonstrated between the results of the carotene-loading test and the jejunal mucosal morphology in patients with duodenal ulcer. This may in part be explained by the possible existence of patchy rather than uniform jejunal changes.

4. Two of 22 postgastrectomy duodenal ulcer patients had abnormal jejunal biopsies. Both of these patients exhibited significant weight loss and persistent diarrhea.

5. The occurrence of subnormal carotene-loading tests in some ulcer patients before gastric resection raises the question that the operation may in some cases serve to unmask a latent malabsorption state.

6. In ulcer patients in whom evidence for impaired absorption is detected prior to surgery, the use of the most conservative surgical procedure feasible should be considered.

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Authors and Affiliations

  1. From the Departments of Medicine and Pathology, Sinai Hospital of Detroit and Wayne State University College of Medicine, Detroit, Mich.

    Joel I. Hamburger M.D., Robert M. Cutler M.D., Marcus H. Sugarman M.D., Saul Brown M.D., J. Edward Berk M.D. & David J. Sandweiss M.D.

Authors
  1. Joel I. Hamburger M.D.
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  2. Robert M. Cutler M.D.
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  3. Marcus H. Sugarman M.D.
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  4. Saul Brown M.D.
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  5. J. Edward Berk M.D.
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  6. David J. Sandweiss M.D.
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Deceased.

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Hamburger, J.I., Cutler, R.M., Sugarman, M.H. et al. Intestinal absorption and jejunal morphology in duodenal ulcer patients. Digest Dis Sci 8, 709–717 (1963). https://doi.org/10.1007/BF02236079

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