J.Jpn. Surg. Soc.. 58(9): 1450-1474, 1957

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AN EXPERIMENTAL ETIOLOGICAL STUDY OF THE GASTRIC OR DUODENAL ULCERATION FOLLOWING LIGATION OF THE COMMON BILE DUCT

The etiologic significance of HCl in gastric juice in the development of erosions or ulcers in the stomach or duodenum to be produced by ligation of the common bile duct was explored in dogs. The erosions or ulcers in mucosa of the stomach or duodenum produced by ligation of the common bile duct with concomitant reduction of secretion of HCl in gastric juice were sometimes due to hemorrhage or necrosis, but in the majority were due to inflammatory prosess. Furthec, the changes in the mucosa of the pyloric glandullar area and that of the duodenum which were absolutely freed from HCl in gastric juice by the unilateral pyloric-exclusion with ligation of the common bile duct were studied and the inflammatory erosions were observed in the mucosa of the pyloric glandullar area.
Thus, the hematogenic toxicosis by bile acid is of primary significance as the etiologic factor in the development of erosions and ulcers of the stomach and duodenum produced by ligation of the common bile duct, and HCl in gastric juice is excluded from any significance in the view point of its corrosive action. These results might show the possibility that the erosive gastritis (or duodenitis) or ulcers observable in the human stomach or duodenum might be produced by the hematotoxic factor, in the independence of HCI in gastric juice playing as erosive or inflammatory factor.
(author's abstract)

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