Obstructing pyloroduodenal ulcers and their management

We have analyzed 196 cases of pyloroduodenal obstruction due to peptic ulcer disease. Obstruction occurred in 19% of peptic ulcer patients. Males predominated five to one over females. Diagnosis could usually be made on clinical grounds alone. Air contrast x-ray studies were better than conventional barium meal x-rays and are recommended. Symptoms were relieved with conservative treatment alone in 17% of patients. We suggest that such therapy should take the form of preoperative preparation and that the period between diagnosis of obstruction and surgery should be kept to a minimum. Gastrojejunostomy for drainage was the procedure of choice. Postvagotomy gastric atony was very infrequent.