Usefulness of the chemical properties of gastric juices in gastrectomized patients

This paper aims at assessing the diagnostic value of measuring the acid secretion of the stomach in gastrectomized patients in whom there is suspicion of a recurrent ulcer. Eighty male patients who had been operated on for a duodenal ulcer by simple gastrectomy were studied. In every gastrectomized patient with abdominal epigastric symptoms a study of the secretions of the gastric stump should be carried out, in addition to radiography and gastroscopy, even if the clinical features are not typical of a recurrent ulcer. Almost 25% of the patients with proved anastomotic ulcer had a history which was not very suggestive of a new ulcer. Gastrectomized patients whose maximal acid output (MAO) value exceeds 13 mEq/hr should in principle be regarded as having an anastomotic ulcer. Gastrectomized patients whose MAO values are between 5 and 13 mEq/hr may have a recurrent ulceration but it is also possible that the anastomosis tolerates this acidity without an ulcer forming. Gastrectomized patients with MAO values below 5 mEq/hr are not suspect of having a recurrent ulcer although this cannot be completely excluded. Basal acid output exceeding 5 mEq/hr was only found in patients with an anastomotic ulcer.