J.Jpn. Surg. Soc.. 56(1): 50-65, 1955

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AN EXPERIMENTAL STUDY ON THE INTESTINAL OBSTRUCTION

Having attempted the experiment with healthy, adult female dogs looking for transition of the function of adrenal cortex on the intestinal obstruction and after its release, and pursuing both rise and fall of circulating eosinophils and chemocorticoid in urine, the author obtained the following results.
The mean of circulating eosinophiles in healthy female dogs (before operation) was 655/mm³ (in 61 cases), and that of chemocorticoid in urine was 2.002 mg/day (in 189 cases) by Nakao-Aizawa's method.
In simple laparotomized dogs, chemocorticoid in urine reached a maximum on 24 hours after operation, and showed high average for 3-4 days but decreased thereafter. Circulating eosinophils decreased during 24 hours after the operation but increased there after and eosinophilia was found on the fourth day.
When the intestine was obstructed, chemocorticoid in urine decreased on and after 24 hours and the tendency continued until death. Fall of circulating eosinophils was remarkable after the obstruction and could hardly be found at the end of the stadium.
Decrease of chemocorticoid in urine continued for 1-2 days after the obstruction was released, especially on 24 hours after the release the decrease was rather remarkable than under the intestinal obstruction. Fall of circulating eosinophils was also more remarkable after the release, and its recovery to the normal level was slower compared with the simple laparotomized dogs.
Judging from the above results, the author supposed that decrease of chemocorticoid in urine during the intestinal obstruction and in the early stage after its release is owing to rise of the consumption of corticoids in the body, but, in order to make it sure, the author tried to see rise and fall of chemocorticoid in blood of both adrenal and femoral veins, with the result to be summarized as follows :
Chemocorticoid in blood of adrenal veins increased during the intestinal obstruction and in the early stage after its release while that of the femoral vein decreased. At the same time, chemocorticoid in urine also decreased and therefore it is noticed to run into hypocorticism consuming abnormally adreno-cortical hormone in the body though the secrete from the adrenal gland increased.
At the end of the stadium of the intestinal obstruction, chemocorticoid in blood of the adrenal vein decreased, too. Accordingly, the author guess that one should die due to heavy hypocorticism arising from the decrease of secrete of cortical hormon from the adrenal gland believes therefore, that the active supplemental therapy is necessary against such hypqcorticism under the intestinal obstruction and in the early stage after its release.
Though it is difficult for us to decide what kind, in what way and how much dosage of preparation should be taken, so far as experiment of the author verified, ACTH, cortisone and also DOCA (+Vit. C) were not effective, but A.C.E. will be effective if used sufficiently. In conclusion, L.A.C. (Upjohn Co.) was suitable drug for such cases, and the author says, it suggests us a new way to improve the treatment of intestinal obstruction in the near future.
(author's abstract)

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