Spontaneous Peptic Ulcers of Duodenum After Continued Loss of Total Pancreatic Juice

Reflux of duodenal contents in the pathogenesis of pancreatitis

“…This operation is worthy of further consideration in those cases of chronic relapsing pancreatitis with persistent abdominal pain and pancreatic calcification, bearing in mind the possible complication of peptic ulceration resulting from lack of alkaline pancreatic secretions (Elman and Hartmann, 1931). It would also allow safe biopsy of the outlet of the pancreatic duct and examination of this area for pathological changes in the mucosal 'valvules'.…”

Studies on gastrin: Part II Quantitative study of the distribution of gastrin-like activity the gut

“…The problem seems therefore more academic than practical at present, though final assessment cannot be made until further clinical and experimental evidence is available. Elman and Hartmann (1931) found experimental evidence suggesting a role of the pancreas in the causation of peptic ulceration when they observed that diversion of the exocrine pancreatic secretion away from the duodenum almost invariably led to duodenal ulceration. Total pancreatectomy with similar deprivation of the alkaline pancreatic juice, however, rarely did so (Dragstedt, Clark, and Vermeulen, 1939).…”