The Management of Peptic Ulcer—An Internist's Approach

Gastric and duodenal ulcers are common conditions. There is a good natural tendency to heal but medical care does facilitate healing and the prevention of relapse. Bed rest, light diet and attention to the anxiety factor still pay dividends. Unfortunately there have not been any major medical advances in recent years.With gastric ulcer, careful clinical and radiological observations will enable simple and malignant ulcers to be distinguished with considerable accuracy.The risk of gastrectomy is less than the risk of leaving a persistently unhealed ulcer, and should be undertaken if ulcers remain unhealed or if there are frequent relapses threatening economic security.     

ANNULAR PANCREAS—Peptic Ulcer as Late Postoperative Sequela

Two cases of annular pancrease with late postoperative sequelae of duodenal and gastric ulcer are presented. In each case operation was limited to the annulus. Because symptoms are not permanently relieved by this procedure and subsequent peptic ulceration is not prevented, it is suggested that partial gastric resection be performed and decompression of the duodenal stump be effected by resection of the pancreatic ring.     

ALCOHOLISM—Medical Team Approach to Treatment

Various approaches to the treatment of alcoholism have been evaluated by the Los Angeles Rehabilitation Clinic since it began operating more than four years ago. A team approach similar to that used in the outpatient treatment of other chronic disabling diseases has been formulated. With the permission of the California State Department of Public Health (Division of Alcoholic Rehabilitation) preliminary figures of the follow-up study conducted by this department are presented and would tend to support the conclusion that alcoholism can be successfully treated on an outpatient basis.