Comparative Frequency of Peptic Ulcers After Deprivation of Bile and Pancreatic Juice

Abstract

Berg and Jobling 1 reported the occurrence of peptic ulcers in dogs following the deprivation of bile. These findings were corroborated by Kim and Ivy 2 and Bollman and Mann. 3 The incidence of ulcers was approximately 60%.

During the past few years, in connection with other investigations, we have examined a number of animals deprived of their pancreatic secretions by means of fistulas, ligation of the pancreatic ducts, and pancreatectomy, and have been impressed by the infrequent occurrence of peptic ulcers in these animals compared to dogs in which bile was excluded. On the other hand, Elman and Hartmann 4 found ulcers in the duodenum in all of the animals of a series of 6 dogs with pancreatic fistulas existing from 13 days to 18 days. They described the lesions as ulcers, although microscopic examination revealed only defects in the continuity of the mucosa, not involving the deeper muscular layers of the intestine. These investigators attributed the lesions to the loss of the neutralizing effect of pancreatic juice upon gastric acidity, and minimized the importance of bile as a factor in the development of peptic ulcers in dogs.

The following observations were made upon a series of 14 dogs deprived completely of pancreatic juice by means of fistulas made according to the technique of Rous and McMaster, as adapted by Elman and McCaughan. 5 Twelve of the animals received sodium chloride by mouth or intravenously; 2 received no special form of treatment and were killed after 25 days and 31 days respectively. Some of the animals were killed while they were still in good condition. Others developed symptoms typical of pancreatic insufficiency 6 and died spontaneously.