J.Jpn. Surg. Soc.. 62(1): 24-44, 1961

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STUDIES ON ADRENOCORTICAL HORMONES DURING THE COURSE OF ILEUS.

The author undertook investigations on the fluctuations of the adrenocortical hormones during the course of ileus, being the endocrinological aspect of the general theme of ileus which is the research project of the Matukura Department of Surgery.
In addition, some problems closely related to these hormones, such as the changes in blood sugar, plasma amino acids and serum electrolytes, have also been determined.
Furthermore, the influences of hypophysectomy and of complete removal of the intestinal tract below the point of obstruction have been studied.
The results obtained may be summarized as follows:
1. During the course of ileus the adrenocortical hormones, as demonstrated by the fluctuations of total urinary 17-hydroxycorticoids, tend to increase in amount, the degree of increment being slight on the 2nd day but attaining the maximal level on the 3rd day after the establishment of ileus. However, when the stage of shock is reached, the hormones show a tendency to decrease in a remarkable degree.
2. The level of blood sugar becomes gradually elevated in the course of ileus but tends to be depressed during the stage of shock. These changes in the blood sugar value are hardly influenced by the administration of DOCA, but are effectively inhibited by cortisone administration even though temporarily.
3. The plasma amino acids are increased during ileus, resulting in a state of so-called amino acidemia is produced during shock. This r emarkable phenomenon, however, can be suppressed, though temporaily, by the administration of cortisone but not by that of DOCA.
4. The adrenocortical hormones. especially the urinary chemocorticoid tend to decrease gradually during the course of ileus, the shock stage being characterized by a remarkable depression.
5. Although serum Na and Cl show a tendency to decrease during ileus, the level of serum K gradually increases. These changes in serum electrolyte values are not particularly influenced by the administration of cortisone, although DOCA administration shows a temporary but definitely inhibitory effect.
6. Hypophysectomy causes a remarkable depression of the adrenocortical hormones, particularly of total urinary 17-hydroxycorticoids, chemocorticoid and 17-ketosteroid, which is most marked on the 15th day after the operation, as compared with the pre operative values. When ileus is established in these hypophysectomized dogs, the urinary adrenocortical hormones follow an unswerving course of depression until death occurs within a short duration of time.
7. When complete excision of the intestine below the point of obstruction is combined simultaneously with acute duodenal ileus, the followieg results have been obtained:
(1) Urinary chemocorticoid tends to decrease gradually with the progress, but, when compared with the changes occurring at the time of acute duodenal obstruction, the decrement is remarkably suppresed so that the survival time is prolonged. (2) The total base of serum gradually decreases, but serum chloride shows a slight increase on the 1st day after operation, gradually decreasing thereafter. When the changes in electrolytes are compared with the fluctuations occurring under acute duodenal ileus, the degree of decrement is remarkably suppressed.
(Author's abstract)

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