Abstract
Clairmont and Haberer 1 first directed attention to the terminal anuria that occasionally accompanies protracted obstruction of the common bile duct. This happening has frequently been observed since then but the mechanism of its occurrence is not well understood. It has been believed that the administration of ether anesthesia to patients with obstruction of the common bile duct has played a significant rôle in precipitating this event.
In this study we had planned to determine whether any of the commonly employed anesthetics have a deleterious influence on the kidney function in the presence of obstructive jaundice. Not having obtained any manifestations of such injury with chloroform or ether no further observations were made with other anesthetics in common use.
The common bile duct was divided and ligated in 16 normal dogs under aseptic conditions. Following the convalescence of the animal, deep ether anesthesia was administered for an hour at brief intervals (usually a week apart) following which the excretion of phenol-sulphon-phthalein and the blood urea and icterus index were obtained on 2 occasions soon after recovery from the anesthetic and again before its repetition a week later. In a few other dogs similarly obstructed, chloroform was administered in one instance by stomach tube and to 4 others by inhalation.
Blocks of tissue from the kidney and liver were obtained at necropsy from all the dogs that served as subjects of these experiments. The kidneys exhibited typical tubular degeneration; in most instances this finding was striking. Fat stains made of the kidney showed a corresponding fatty degeneration of the tubules. Biliary pigment and albumin were usually observed within the lumen of the tubules. Bile pigment was also found deposited within the renal cells.
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