Abstract
We have reported our findings 1 on the influence of simple duodenal obstruction upon the volume of the combined gastric, biliary, pancreatic, and duodenal secretions. In the present work we have studied the influence of closed intestinal loop strangulation upon these same secretions. Twenty-two fasting healthy dogs were used in the study. All had their salivary ducts ligated.
In the first group of animals the duodenum was divided below the entrance of the lower pancreatic duct, a Dragstedt type of intestinal cannula was placed in the proximal duodenum and the cut ends were inverted. A second cannula was placed in the jejunum about 6 to 8 cm. distal to Treitz' ligament. From the duodenal cannula the combined digestive secretions drained into a clean rubber bag. Collections were made every one to 4 hours day and night, measured, and returned by cannula into the jejunum. About 50 cc. of Ringer's solution or tap water were added alternately to the returned secretions. In addition to the fluids mentioned 500 to 1500 cc. of Ringer's solution were given subcutaneously daily to prevent dehydration. The control period lasted from 3 to 7 days. After the animal had fully recovered from the operation and the volume of the secretions had reached a constant level a second operation was performed. The jejunum was divided and the ends inverted just proximal to the jejunal cannula, producing an isolated duodenojejunal loop 15 to 20 cm. long around Treitz' ligament. Following this the collections and replacements were made in the usual manner. When replacement of the secretions was impossible larger amounts of Ringer's solution were given subcutaneously. In the obstructive period vomiting occurred. The volume of vomitus was prorated and added to the amounts of secretion collected.
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