Clinical Experiences in Gastric Freezing for Peptic Ulcer

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GASTRIC cooling for the control of hemorrhage from the upper gastrointestinal tract has enjoyed variable popularity for many years.1,2 Cooling has been attempted by external application of ice packs to the abdomen, or by lavage of the stomach with ice water to which epinephrine and other medications sometimes have been added. In 1958 the method was improved and standardized by Wangensteen, with the goal of depressing gastric secretion and digestion.3 In 1962, he and his associates4 reported the use of still lower temperatures for gastric hypothermia (“freezing”) in the definitive treatment of duodenal ulcer, the goal being permanent suppression of gastric secretion.

Research and clinical experiences at the Cleveland Clinic since I960 with gastric cooling in animal and human subjects, respectively, and six months’ experience with gastric freezing in animals, encouraged us to commence in March, 1963, the treatment of peptic ulcers by gastric cooling in a series of selected patients. Dr. Owen H. Wangensteen kindly permitted a visit to his department to observe the technic of his group. The reference gives complete details of the technic,5 which is described briefly here. A specially shaped deflated balloon is passed into the stomach and is then filled with the coolant, 95 percent alcohol, to a volume of 400 to 950 ml. depending on gastric size and tolerance. The coolant is circulated constantly between the balloon and a reservoir in a specially constructed refrigerator. The temperature of the coolant entering the balloon is approximately —17 C., and leaving the balloon, about —. . .



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