Marginal ulcer in achlorhydric patients.

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Recurrent gastrojejunal ulceration can occur after surgery.
• Histamine-fast achlorhydria is a condition of reduced stomach acid production.

Purpose of the Study:

• To investigate the causes of recurrent gastrojejunal ulceration in patients with achlorhydria.
• To determine if achlorhydria protects against anastomotic ulceration.

Main Methods:

• Case study of three patients with recurrent gastrojejunal ulcers and histamine-fast achlorhydria.
• Review of patient histories for contributing factors such as suture material, alcohol, and aspirin abuse.

Main Results:

• None of the patients had ulceration caused by extruding suture material.
• All three patients had a history of alcohol abuse; one also abused aspirin.
• Achlorhydria did not prevent gastrojejunal ulceration in these cases.

Conclusions:

• Achlorhydria does not confer protection against anastomotic ulceration.
• Surgical manipulation may increase susceptibility to mucosal damage.
• Anastomotic ulceration should not always be attributed to acid peptic disease recurrence.