Abstract
In a previous communication one of us (H. P. J. 1 ) found that high intestinal obstruction with the biliary, pancreatic, and duodenal secretions short-circuited below the obstructed point was compatible with life for 12-33 days, with considerable changes in the blood chemistry over this period.
In the present experiments the obstruction was produced in the lower ileum 30-70 cm. from the caecum. The animals were prepared for the obstruction by a preliminary operation in which the pylorus was resected and gastro-jejunostomy performed. At a second operation the jejunum just beyond the ligament of Treitz and proximal to the gastro-jejunostomy was sectioned and the proximal end anastomosed to the lower ileum. The ileum just above this anastomosis was also sectioned. The free sectioned ends of the bowel were invaginated with purse string sutures. In this way the biliary, pancreatic, and duodenal secretions emptied into the lower ileum, and the stomach drained into the long obstructed loop of jejunum and upper ileum.
In 7 dogs the length of life after the second operation varied from 2 to 20 days, averaging 10 days. Vomiting occurred about every 2nd or 3rd day. The animals took fluids by mouth fairly well. The urine output averaged 150-350 cc. per day. Studies of the blood chemistry showed only a moderate fall in the chlorides in a few instances, whereas in several it was practically the same as before operation. Carbon-dioxide combining power did not show any constant marked change. The non-protein nitrogen was inclined to rise in several of the animals. At autopsy the stomach showed slight distension, the characteristic finding being a marked dilatation of the terminal portion of the obstructed bowel, which in some animals was 5 cm. in diameter.
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