Blood Chemistry in Intestinal Obstruction.

Abstract

The work of Tileston and Comfort, 1 Whipple and his associates, 2 Mac Callum, 3 Hastings, 4 Haden and Orr, 5 and others has demonstrated that obstruction in the upper intestinal tract produces characteristic changes in the blood chemistry. These may be summarized as follows: a decrease in the concentration of chlorides, a late increase in non-protein and urea nitrogen, and an increase in the carbon dioxide combining power of the blood plasma. As a result of a number of experiments reported by L. R. Dragstedt, 6 C. A. Dragstedt, 7 P. R. Cannon, 8 and their associates from 1916 to 1921, these authors concluded that the toxemia of intestinal obstruction was due to the absorption of chemical fractions produced by the proteolytic activity of the intestinal bacteria and that the factor permitting their absorption was circulatory damage to the intestinal mucosa as a result of distention. In the present experiments determinations were made of the non-protein nitrogen, urea nitrogen, and chloride concentration in the blood of dogs subjected to the various procedures described in the early reports. The following points are brought out.