Abstract
Although numerous methods have been employed to produce peptic ulcers experimentally, 1 the frequent occurrence of ulcers of the duodenum in dogs with bile fistulas has not been described. Bickel, 2 Exalto 3 and Mann 4 found ulcers in the jejunum after diverting the duodenal, biliary and pancreatic secretions away from the stomach and performing a gastro-jejunosotomy. Mann also found ulcers in the duodenum by transplanting the pancreatic and bile ducts into the lower ileum. It was considered that an important factor in the development of these ulcers was the loss of the neutralizing effect of the alkaline secretions upon gastric acidity. According to Boldy-reff, 5 the alkalinity of the pancreatic secretions was greater than that of all the others combined and was the chief element in the neutralization of the gastric juice.
In a series of dogs with bile fistulas, we noted at autopsy the prevalence of duodenal ulcers. The fistulas were made according to the method of choledochostomy described by Rous and McMaster 6 which permitted the collection of the total output of hepatic bile and deprived the animals completely of their biliary secretions. The dogs could not lick the fistulous openings, and accessory communications between the common duct and the intestine were ruled out at autopsy.
The series consisted of 9 dogs which lived for periods extending from 12 days to 46 days. There were 8 males and one female. The ages varied. The diet consisted of combinations' of biscuit, bread, meat, oatmeal, cod liver oil and bones, with water ad lib. Fat was removed as completely as possible from the food. Two dogs received liver, in addition to the other food.
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