c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Upper Gastrointestinal Bleed: 10

A D V E R T I S E M E N T

   
 

Pyloroplasty is done in combination with truncal vagotomy to prevent the 40% incidence of subsequent functional pyloric outlet obstruction. It is also indicated when recurrent pyloric channel ulcers have created a rigid pyloric stricture secondary to scar tissue. For the latter indication, the Finney or Joboulay are best suited. In emergency situations, the Heineke-Mijulicz is simplest. All are started by Kocherizing the duodenum.     

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Upper Gastrointestinal Bleed: 11

A D V E R T I S E M E N T

   
 

The serosal layer was closed with interrupted Lembert sutures of 3-0 silk.       

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Upper Gastrointestinal Bleed: 12

A D V E R T I S E M E N T

   
 

An alternate method of closure is the single layer Gambe stitch which inverts the mucosa.       

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This page was last modified on 2/28/2001.