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February 1961, Vol 101, No. 2 >
Article | February 1961

Duodenal Ulceration and Fibrocystic Pancreas Disease FREE

K. ATERMAN, M.D., Ph.D., M.R.C.P., D.C.H.
[+] Author Affiliations

Submitted for publication May 17, 1960.

The Children's Hospital, Halifax.


Am J Dis Child. 1961;101(2):210-215. doi:10.1001/archpedi.1961.04020030074012.
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Comments

Although cystic fibrosis of the pancreas is now one of the most widely studied diseases of childhood, the association of this disease with ulceration of the duodenum has only infrequently been reported. On theoretical grounds, such an association would, however, be expected, since the development of ulcers of the duodenum following the diversion of pancreatic juice from this part of the intestine has been clearly demonstrated in the experimental animal by such early observers as Mann and Williamson,1 Elman,2 and Dragstedt.3

More recently, Poth and Fromm4 have similarly implicated the deficient neutralization of acid in the duodenum because of pancreatic insufficiency as a factor in the causation of peptic ulceration. It may be of interest in this connection to draw attention to the findings of Shwachman and Leubner5 who noted that, in a large proportion of cases of cystic fibrosis of the pancreas studied by

REFERENCES

1 +
Mann, F. C., and Williamson, S. C.:  The Experimental Production of Peptic Ulcer , Ann. Surg. 77:409, 1923;.
2 +
Elman, R.:  Spontaneous Peptic Ulcers of the Duodenum Following the Total Loss of Pancreatic Juice , J. Clin. Invest. 10:183, 1931;.
3 +
Dragstedt, L. R.:  Some Physiologic Problems in Surgery of the Pancreas , Ann. Surg. 118: 567, 1943;.
4 +
Poth, E. J., and Fromm, S. M.:  The Relation of Pancreatic Secretion to Peptic Ulcer Formation , Southwestern Med. 33:16, 1952;.
5 +
Shwachman, H., and Leubner, H.: Mucoviscidosis, Advances in Pediatrics , edited by S. Z. Levine, 7:249, 1955;.
6 +
Wurm, H.:  Ulcus duodeni mit Pankreasentwicklungsstörung bei einem 7 Wochen alten Säugling , Ztschr. Kinderh. 43:286, 1927;.
7 +
Markel, I. J.:  Fibrocystic Disease of the Pancreas with an Unusual Lesion , J. Indiana M.A. 37:674, 1944;.
8 +
McAleese, J. J., and Sieber, W. K.:  The Surgical Problem Presented by Peptic Ulcer of the Stomach and Duodenum in Infancy and Childhood , Ann. Surg. 137:334, 1953;.
9 +
Bodian, M., Editor: Fibrocystic Disease of the Pancreas: A Congenital Disorder of Mucus Production—Mucosis , New York, Grune and Stratton, 1953;.
10 +
Bachmann, K. D.:  Die sogenannte cystische Pankreasfibrose: Mucoviscidosis , Erg. inn. Med. Kinderh. 8:316, 1957;.
11 +
Andersen, D. H.:  Cystic Fibrosis of the Pancreas , J. Chronic Dis. 7:58, 1958;.
12 +
Koch, E.:  Hereditary Adult Mucoviscidosis and Its Relationship to Peptic Ulcer , German Med. Monthly 5:40, 1960;.
13 +
Editorial:  Mucoviscidosis in Adults , Lancet 1:963, 1960;.
14 +
Robbins, S. L.: Textbook of Pathology, with Clinical Applications , Philadelphia, W. B. Saunders Company, 1957;.
15 +
Stowens, D.: Pediatric Pathology , Baltimore, Williams and Wilkins Company, 1959;.
16 +
Anderson, W. A. D., Ed.: Pathology , Ed. 3, St. Louis, C. V. Mosby Company, 1957;.
17 +
Gray, S. J.; Benson, J. A.; Reifenstein, R. W., and Spiro, H. M., Jr.:  Chronic Stress and Peptic Ulcer: I. Effect of Corticotropin (ACTH) and Cortisone on Gastric Secretion , J.A.M.A. 147: 1529, 1951;.
18 +
Gray, S. J.; Ramsey, C. G.; Reifenstein, R. W., and Benson, J. A., Jr.:  The Significance of Hormonal Factors in the Pathogenesis of Peptic Ulcer , Gastroenterology 25:156, 1953;.
19 +
Kirsner, J. B.:  Hormones and Peptic Ulcer , Bull. New York Acad. Med. 29:477, 1953;.
20 +
Soffer, L. J.: Diseases of the Adrenals , Ed. 2, Philadelphia, Lea & Febiger, 1948;.
21 +
Turner, F. P.:  Peptic Ulcer and the Pituitary-Adrenal System , cited by Kirsner,19 J. Maine M.A. 42:170, 1951;.
22 +
Selye, H.:  The General Adaptation Syndrome and the Diseases of Adaptation , J. Clin. Endocrinol. 6:117, 1946;.

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References

1 +
Mann, F. C., and Williamson, S. C.:  The Experimental Production of Peptic Ulcer , Ann. Surg. 77:409, 1923;.
2 +
Elman, R.:  Spontaneous Peptic Ulcers of the Duodenum Following the Total Loss of Pancreatic Juice , J. Clin. Invest. 10:183, 1931;.
3 +
Dragstedt, L. R.:  Some Physiologic Problems in Surgery of the Pancreas , Ann. Surg. 118: 567, 1943;.
4 +
Poth, E. J., and Fromm, S. M.:  The Relation of Pancreatic Secretion to Peptic Ulcer Formation , Southwestern Med. 33:16, 1952;.
5 +
Shwachman, H., and Leubner, H.: Mucoviscidosis, Advances in Pediatrics , edited by S. Z. Levine, 7:249, 1955;.
6 +
Wurm, H.:  Ulcus duodeni mit Pankreasentwicklungsstörung bei einem 7 Wochen alten Säugling , Ztschr. Kinderh. 43:286, 1927;.
7 +
Markel, I. J.:  Fibrocystic Disease of the Pancreas with an Unusual Lesion , J. Indiana M.A. 37:674, 1944;.
8 +
McAleese, J. J., and Sieber, W. K.:  The Surgical Problem Presented by Peptic Ulcer of the Stomach and Duodenum in Infancy and Childhood , Ann. Surg. 137:334, 1953;.
9 +
Bodian, M., Editor: Fibrocystic Disease of the Pancreas: A Congenital Disorder of Mucus Production—Mucosis , New York, Grune and Stratton, 1953;.
10 +
Bachmann, K. D.:  Die sogenannte cystische Pankreasfibrose: Mucoviscidosis , Erg. inn. Med. Kinderh. 8:316, 1957;.
11 +
Andersen, D. H.:  Cystic Fibrosis of the Pancreas , J. Chronic Dis. 7:58, 1958;.
12 +
Koch, E.:  Hereditary Adult Mucoviscidosis and Its Relationship to Peptic Ulcer , German Med. Monthly 5:40, 1960;.
13 +
Editorial:  Mucoviscidosis in Adults , Lancet 1:963, 1960;.
14 +
Robbins, S. L.: Textbook of Pathology, with Clinical Applications , Philadelphia, W. B. Saunders Company, 1957;.
15 +
Stowens, D.: Pediatric Pathology , Baltimore, Williams and Wilkins Company, 1959;.
16 +
Anderson, W. A. D., Ed.: Pathology , Ed. 3, St. Louis, C. V. Mosby Company, 1957;.
17 +
Gray, S. J.; Benson, J. A.; Reifenstein, R. W., and Spiro, H. M., Jr.:  Chronic Stress and Peptic Ulcer: I. Effect of Corticotropin (ACTH) and Cortisone on Gastric Secretion , J.A.M.A. 147: 1529, 1951;.
18 +
Gray, S. J.; Ramsey, C. G.; Reifenstein, R. W., and Benson, J. A., Jr.:  The Significance of Hormonal Factors in the Pathogenesis of Peptic Ulcer , Gastroenterology 25:156, 1953;.
19 +
Kirsner, J. B.:  Hormones and Peptic Ulcer , Bull. New York Acad. Med. 29:477, 1953;.
20 +
Soffer, L. J.: Diseases of the Adrenals , Ed. 2, Philadelphia, Lea & Febiger, 1948;.
21 +
Turner, F. P.:  Peptic Ulcer and the Pituitary-Adrenal System , cited by Kirsner,19 J. Maine M.A. 42:170, 1951;.
22 +
Selye, H.:  The General Adaptation Syndrome and the Diseases of Adaptation , J. Clin. Endocrinol. 6:117, 1946;.

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