Abstract
About a year ago I reported a case of duodenal perforation successfully treated by jejunal alimentation.1As these cases are rare and of difficult management I take the liberty of reporting another case with duodenal fistula which I recently had under observation in conjunction with Dr. Willy Meyer. REPORT OF CASE History. —A. P. P., man, aged 50, born in the United States, seen. May 10, 1919, was first seized twenty years before with an attack of pain and gas in the epigastrium, which lasted several hours. Eight years later, he had three attacks in a period of three months. Five years later, the attacks came on more frequently and then disappeared until the past six or seven years, when they came on two or three times a year. The attacks were sudden, lasted at the utmost twentyfour hours, disappeared, and would not recur for a long period. During

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