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Six patients (three women and three men) who had upper gastrointestinal hemorrhage due to Mallory-Weiss syndrome are described. Retching was the most common precipitating factor (5/6) followed by vomiting (2/6). Basic underlying causes for either retching or vomiting were probable excess alcohol consumption (3/6), side-effects of oral or parentral medication (2/6) and over-indulgence in eating after partial gastrectomy (1/6). The two most important factors leading to confirmation of the diagnosis were: 1. History of events prior to the onset of upper gastrointestinal hemorrhage and 2. early panendoscopy. One noted feature of the present series is the high incidence of other silent co-existing pathological lesions at the time of endoscopic examination. Upper gastrointestinal hemorrhage was characterized as mild to moderate (800-500 cc.) in three patients and moderate to severe (1,000-2,000 cc,) in another three patients. All recovered under medical management and none required surgical intervention. It is becoming increasingly evident that such a benign outcome in Mallory-Weiss syndrome is more common than previously recognized. [ABSTRACT FROM AUTHOR]

Discusses the case of patient with ampullary carcinoma in which jaundice spontaneously cleared for a period and serum bilirubin levels remained normal despite the presence of fatal metastases. Medical history of the patient; Cause of ampullary carcinoma; Description of the gallbladder, extrahepatic biliary tree and pancreatic ducts based on a postmortem examination of the patient.

Presents clinical information on primary hypertrophic pyloric stenosis in adults. Pathological description of the lesions in the stomach; Ulcers associated with hypertrophy of the pyloric musculature; Prevalence of the disease in males; Symptoms associated with the disease.

The Olympus EF esophagoscope has certain features which make it an excellent instrument for the examination of the distal esophagus, upper stomach, and gastroenteric stomas. It is not satisfactory for antral lesions. The directable tip and straight-ahead viewing permit visualization and biopsy of some lesions at the cardia not seen with the rigid open-tube esophagoscope. Accurate biopsy in the upper half of the stomach can be accomplished readily with this instrument. Maneuverability is such that gastroenteric stomas can be thoroughly examined; often the instrument can be made to enter the small intestine through the stoma. Photographs and biopsies are readily obtained and aid in documentation of the diagnosis. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluated the incidence of postvagotomy stasis in a group of 102 patients who required operation for peptic ulcer. Fractional gastric analysis was performed preoperatively in all patients. Complications from operation for peptic ulcer include wound infection, cardiac failure and pancreatitis.

Pulmonary insufficiency is frequently associated with a peptic ulceration that has a high incidence of explosive complications necessitating surgery in spite of the hypoxia and hypercapnia that occurs during the preoperative, operative and postoperative periods. Undetected and untreated hypoxia and/or hypercapnia results in acidosis and its hypotension, decreased cardiac output, ventricular arrythmia and cardiac standstill. Both may simulate anesthetic narcosis and can only be identified early by serial pH and arterial gas studies. Treatment consists of adequate airway, O2 by head tent or controlled ventilation and intravenous buffers for marked acidosis or persistent narcosis. [ABSTRACT FROM AUTHOR]

Presents abstracts of several medical studies on gastroenterology. "Carcinoma of the Gastrointestinal tract," by Norman C. Tanner; "A Case of Multiple Gastric Leiomyomata With Sarcomatous Changes," by G. H. Herd; "Mechanisms Protecting Against Gastroesophageal Reflux: A Review," by Michael Atkinson.

Examines the nature and to indicate the management of certain complications of partial gastric resection for peptic ulcer. Intraperitoneal infection due to spillage at surgery; Proximal loop syndrome; Jejunal adhesions; Pancreatitis.

Resting lower esophageal sphincter pressures and fasting serum gastrin levels were measured in 35 consecutive patients. 28 of these patients were subdivided into Group I, which consisted of 9 patients with symptomatic gastroesophageal reflux and hiatus hernia, and Group II was further subdivided into Group IIA, 5 patients with hiatus hernias, and Group IIB, 14 patients without hiatus hernia. Mean LES pressures for Groups I, IIA, and IIB were 9.7, 36.8, and 25.6 cm H2O, and serum gastrin levels were 129, 74, and 116 pg/ml, respectively. Examination of these data as a whole or as subgroups failed to demonstrate a correlation between these two variables. The remaining 7 patients had abnormal sphincters (3 patients which scleroderma and 2 with achalasia) or abnormal serum gastrin levels (1 patient with pernicious anemia and 1 patient with antrectomy and Billroth II anastomosis). For these patients as well, no correlation between LES pressure and serum gastrin level was found. These results cast doubt on the hypothesis that endogenous gastrin is a major factor in the maintenance of resting LES pressure.