The Special Significance of Concomitant Gastric and Duodenal Ulcers

Hiatal Hernia in Bronchial Asthma

“…The importance of pleurisy with its consequences has been emphasized [45,61]. Emphysema and chronic bronchitis are often stressed in the literature [4,11,56], A somewhat higher frequency of hiatal hernia as a concomitant disorder in cases of disease of the gallbladder, peptic ulcer and diverticulosis seems to be substantiated [10,27,30,40,51,64]. It is said that the chronic irritation of the nervus vagus in * Clémençon (1957): Hiatal hernia in bronchial asthma (unpublished).…”

Gastric ulcers, blood groups, and acid secretion

“…Two years later a pilot survey of 523 typed gastric ulcers was published (Johnson, 1957b) and it was reported that the combined ulcers and also the prepyloric ulcers were associated both with acid hypersecretion and, in this series, with a group 0 excess even greater than any previously reported for duodenal ulcers. These two kinds had indeed been responsible for the whole of the overall group 0 preponderance of the series, for the other gastric ulcers, some 60% of the total, as well as being in subjects characterized by well-marked hyposecretion, were also apparently more apt to occur in subjects with group A rather than group 0 blood.…”

“…Since the operation of vagotomy (alone) resulted in gastric retention one of us hazarded a guess that it too might lead to a gastric ulcer (Johnson, 1948). Before long this was indeed one of the reasons why vagotomy alone was abandoned.…”

“…It was also pointed out that these patients might be guessed to have a blood group distribution characteristic of the earlier, duodenal lesion, and that the smaller group 0 preponderance in gastric ulcer subjects might all come from those of them who had combined lesions (Johnson, 1955b). Accordingly an investigation of the possibility was begun by collecting gastric ulcer cases and dividing them into types.…”

Non-incidental Concomitancy of Gastric and Duodenal Ulcers

“…Finally, Dragstedt (1956) has developed the socalled retention theory. Johnson (1955 and) studied 130 cases of concomitant gastric and duodenal ulcers, and concluded that, (1) duodenal ulcer usually precedes, (2) gastric retention is seen in many cases, (3) pyloric stenosis is frequent, and (4) concomitant ulcers show appreciable resistance to therapeutic measure as compared with cases of single gastric ulcer. Huber and Huntington (1948) and Murray et al (1967) also supported this theory.…”