Abstract
By means of a method previously described, 1 bile from normal and diseased gall bladders and from biliary tract fistulae was analyzed for bile acids conjugated with taurine and with glycine, cholic acid, deoxycholic acid, total bile acids, and free bile acids. Duodenal drainage material was analyzed for cholic acid, deoxycholic acid and total bile acids. Some of the results are summarized in Table I.
A perusal of Table I shows that in a series of 24 cases of chronic cholecystitis (No. 2, Table), the average figure for the percentage of cholic acid in relation to the total bile acids was 28% as compared to the normal of about 50%. The average figure for the ratio of free bile acids rose from a normal of about 10% to 25%. This deviation in the ratio of the different bile acids is more marked in the gall bladder bile in acute cholecystitis. In 14 of these cases (No. 3, Table) the cholic acid averaged only 13% of the total bile acids. It was found difficult to estimate the free bile acids in a number of cases, since gall bladder bile from acute cholecystitis cases often contained an alcohol soluble material which yielded amino nitrogen on hydrolysis. This not only gave a false result, but also masked the presence of free bile acids. Two typical cases are presented in the table. In the first, (No. 3A) 75% of the total was found to be free bile acids; in the second case, (No. 3B) estimation of bile acids by the Schmidt-Dart method (nitrogen hydrolysis) yielded a figure much greater than the total bile acids. At the same time no trace of cholic acid was found.
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