Acute Dilatation of the Stomach. ∗

Abstract

In a previous communication we 1 have reported that the total loss of gastric juice from the body causes death in the dog in from 5 to 10 days, with symptoms of depression and marked changes in the blood chemistry. These may be summarized as follows: a progressive decrease in the concentration of blood chloride, an increase in the CO₂ capacity, an increase in the pH, and a late increase in the NPN and Urea N. Water and salts are not absorbed to any appreciable extent in the stomach or duodenum and it is therefore clear that any factor such as obstruction at the pylorus or in the duodenum, gastric or duodenal fistula, or profuse persistent vomiting, will lead to this loss of gastric juice constituents through failure of reabsorption in the lower intestine. It is likely that the property of the gastric mucosa, by virtue of which it can continue to separate the elements for its secretion from the altered blood plasma until death is produced, is of major importance in the pathogenesis of these disorders. In the present communication we wish to report a case of acute post-operative dilatation of the stomach together with evidence which indicates that here also the failure of reabsorption of gastric juice is the cause of death.

The patient, a female of 70, was brought to the hospital with a strangulated femoral hernia. The findings are unimportant for the purpose of this paper except for the blood chemistry report, which is as follows: Chloride 196 mg., CO₂ 60 cc.; Urea N 14.0 mg., and NPN 31 mg.

There had been no vomiting. A blood transfusion (500 cc. citrated blood) was given and a section of gangrenous ileum, imprisoned in the hernial sac, resected.