Abstract
Gall bladder disease is a factor common to the majority of cases of acute pancreatic necrosis. The mechanism by which gall bladder disease predisposes to pancreatic necrosis has not been established. In this study we have tried to evaluate the factor of reflux through the agency of mechanical obstruction at the ampulla in the cat. The terminal portion of the common bile duct embedded in the wall of the duodenum was exposed and a ligature placed creating a common channel of the bile and pancreatic ducts.
The criterion of pancreatic necrosis used in this work was the actual histological demonstration of necrosis in the pancreas. Postmortem autolysis and fat necrosis were differentiated from true pancreatic necrosis by the absence of microscopic cellular reaction in these areas.
In a group of 7 cats, 1 developed pancreatic necrosis following simple establishment of ampullary obstruction. In another group air was injected into the gall bladder at the time the obstruction was established until the gall bladder became so distended that its contents were spontaneously evacuated. Through the agency of the block at the ampulla regurgitation occurred into the pancreatic duct. In a group of 13 cats, 8 developed pancreatic necrosis. The pressure in the common bile duct occasioned by the emptying of the gall bladder was measured in 5 cats and was found to vary between 190 mm. and 240 mm. water.
In another group ampullary obstruction was established and gastrostomy was also done, after which the cats were given frequent feedings of olive oil, cream, and bile salts through the gastrostomy tube. Of 31 cats pancreatic necrosis was observed in 15.
To another group alcohol was fed through the gastrostomy tube. Of 9 cats, 2 developed pancreatic necrosis.
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