Effect of Simple Duodenal Obstruction upon the Combined Gastric,Pancreatic,Biliary and Duodenal Secretions. ∗

Abstract

Dragstedt and Dragstedt 1 found in anesthetized animals prepared for the simultaneous collection of gastric, pancreatic and duodenal secretions that the intravenous injection of sublethal doses of fluid obtained from an obstructed duodenum or a closed intestinal loop produced “a striking increase in all of the secretions . . . . ” Ivy et al. 2 later reported that in 7 animals with Pavlov pouches of the stomach the production of a pyloric stenosis decreased at first the secretion of the pouch in response to a test meal. Later 4 of the 7 animals showed a moderate “hypersecretion”. Dragstedt, Montgomery, Ellis and Matthews 3 stated that the experiments referred to above 1 “suggest that under conditions similar to those existing in acute dilatation of the stomach, there occurs an absorption of toxic substances from the duodenum which have a pronounced secretogogue action”. Recently Sungchin Kim 4 observed an increase in the amount of gastric juice in dogs with a duodenal obstruction.

These experiments differ from the conditions seen in patients with acute intestinal obstruction in so far as the use of anesthesia and the intravenous injection of loop fluid 1 are abnormal and the influence of distention as a possible factor in secretion is absent in the Pavlov pouch experiments. We have, therefore, reexamined the subject under conditions which somewhat more naturally simulate the disorder.

In 7 healthy dogs weighing between 10 and 18 kg. the duodenum was divided below the lower pancreatic duct. A Dragstedt type of intestinal cannula was placed in the duodenum proximal to the division. From this cannula the combined gastric, pancreatic, biliary, and duodenal secretions were allowed to run freely into a clean rubber bag. Collections were made every one to 5 hours. The animals were muzzled or their salivary ducts were ligated in order to reduce or eliminate saliva as a factor. No food was given. Two of the animals were discarded because the ingestion of gauze and other materials caused a premature blocking of the cannula. The other 5 may be divided into 2 groups.