Initial Emptying Time of Stomach in Primigravidae as Related to Evacuation of Biliary Tract. ∗

Abstract

Previous studies 1 have shown that in the second and third trimesters of pregnancy the gall bladder of 13 gravida discharged an average of only 49% of contents (within 40 minutes after a standard meal of egg-yolk) as compared with an average discharge of 73% obtained from 12 nulligravidae; that the best 8 of the 13 discharged an average of only 57% and the remaining 5 an average of only 38%; but when the latter were tested 6 to 8 weeks postpartum, the amount of bile discharged in the 40-minute period (71%) approximated the nulligravid figure.

The present study has attempted to ascertain whether this retardation in rate of emptying of the gall bladder in pregnancy could have been due to a delay in the initial rate of emptying of the stomach. To this end 17 nulligravidae (nursing students) were examined fluoroscopically after receiving a 7 standard meal of egg-yolk to which 3 heaping teaspoons of barium sulphate had been added. They were then used as controls for 18 primigravidae of the second and third trimesters, similarly treated. Fluoroscopic observations were supplemented by films. In addition to recording the time of the first spurt into the bulb, and the length of time required for the head of the meal to reach the pars inferior duodeni and the jejunum, an attempt was made to estimate the amount discharged from the stomach during the first 15 minutes. After the above tests were concluded, it was ascertained by experiment that 10 cc of egg-yolk (2/5 of a swallow) was 1 enough to induce evacuation of 72% of the s contents of the gall bladder in 35 minutes, 3 when injected directly into the duodenum.