Total Gastrectomy

Abstract

The following case is reported to point out several features. First, the tardiness with which these patients present themselves. This patient had gastric symptoms for a year before the diagnosis was made, a situation which has a distinct bearing upon operability and curability. Second, total gastrectomy is a feasible operation in selected cases, as many reports in the past ten years have indicated. This patient had sixteen months of comfortable productive life, whereas, I am sure, ten years ago total gastrectomy would have been considered impractical. Third, this case demonstrates that without any anti-anemic therapy the patient was able to maintain an active life and a stationary weight with a normal blood volume and cell counts.

CASE REPORT

A man, 44 years of age, was admitted to the hospital in April, 1940. He complained of a dull, gnawing epigastric discomfort of one year’s duration, which occurred immediately after meals and was not relieved by food or antacids. There had never been any nausea or vomiting. The bowel habits were normal and no tarry stools had been noted. The patient had lost 20 pounds in weight since the onset of his illness, which he attributed to a gradual loss of appetite.

Physical examination revealed no abnormalities. The patient weighed 206 pounds, and appeared to be in good general health. No abdominal masses, organs, or clavicular nodes were palpable. Examination of the rectum was negative. The red blood cells numbered 4,900,000, and the hemoglobin was 91 per cent.

A roentgenogram of the. . .