Excerpt from Annals of Surgery, Vol. 46: A Monthly Review of Surgical Science and Practice; July-December, 1907 Examination of the case in which regurgitant vomiting had occurred and it revealed the cause of the trouble. Death occurred with jaundice, ascites and emaciation, the cancer of the pylorus, for which the original operation was performed, having spread to the liver. When the parts were examined the jejunum was seen to be attached very close to the flexure along Mayo's line, and from the anastomosis the gut passed downwards and to the left into the kidney pouch; it was free from adhesions throughout. But between the flexure and the anastomosis a distinct twist was seen in the jejunum. It was as though the bowel before being applied to the stomach had been rotated around its longitudinal axis. The amount of the twist was small, but quite perceptible; and it was of course more appreciable since it was confined to that portion of the gut, just about one inch in length, which lay between the flexure and the uppermost point of the sutured line. When the anastomosis was separated, the opening in the jejunum was seen to be not exactly opposite the line of attachment of the mesentery. The rotation of the jejunum around its longitudinal axis, the flexure of course being fixed, had, I make no doubt, been ample to cause that partial obstruction of the gut that was responsible for the vomiting of bile. I think it more than probable that the same condition must have existed in those cases, related by Dr. Mayo and Dr. Munro, in which vomiting followed the application of the jejunum to the stomach along the line from above downwards and to the right. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.