A Case of Peri-Duodenitis with Duodenal Stenosis and Traction Diverticula

? months. In May 1943, a caseous abscess was opened the right paravertebral region at the level of the Qrst lumbar vertebra, and the patient was immobilized ^gain for 4 months. From September 1943 to October 1944 the patient complained of intermittent stabbing Pains in the epigastrium, occasionally diffusing to the back, without any relation to meals, especially occurrinS during the night for a period of 1 to 2 hours and accompanied by nausea and occasional bilious Vomiting. Vomiting did not relieve the symptoms. ^Uring the last 2 months of 1944, the patient's symptoms increased in frequency and severity; during the ^st months of 1945, his troubles became continuous. The pains were then cramp-like, starting in the right hypochondrium and extending to the back, occasionally to the right shoulder and to the lower part of the lumbar spine, and were present most of the day and night. The patient used to refuse any solid food and seek relief in frequent lavages of the stomach and injections of morphia, by which pain was only temporarily suppressed, while it was only relieved by atropine. Habitual constipation, loss of strength and weight (30 lb.). The genupectoral position and Haye's devices did not relieve the pain. Later his vomiting became almost continuous, and the vomit was always tinged with bile. The patient was then sent for surgical treatment to a surgeon, whose report is unfortunately not available. The patient never showed any temperature. . .