Treatment of postgastrectomy stomal ulcer by gastric freezing.

Introduction The development of stomal ulcer following gastric resection for duodenal ulcer, whether manifested by recurrent ulcer symptoms or by upper gastrointestinal tract bleeding, represents a difficult and challenging problem. Almost invariably surgery has been necessary to correct the situation, with vagotomy and/or further resection as the conventional surgical approach. Vagotomy is the simpler and lesser procedure and has been widely employed in the management of stomal ulcer in recent years. Gastric freezing for the definitive control of the peptic ulcer diathesis is a direct outgrowth of successes with milder forms of gastric hypothermia for the control of massive upper gastrointestinal hemorrhage. 1 Gastric cooling for this latter purpose followed studies in frogs and dogs in which it was observed that gastric digestion was completely suspended at temperatures of 10 to 15 C. In fact, subsequent studies have shown virtual suspension of gastric digestion at temperatures below 10 C, as