J.Jpn. Surg. Soc.. 62(1): 45-62, 1961

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STUDIES ON SERUM ANTIDIURETIC SUBSTANCE (ADS) DURING THE COURSE OF ILEUS.

The author made studies on serum antidiuretic substance, with special reference to the condition of the liver, during the course of ileus, as a feature of endocrinological investigation related to the general theme of ileus which is a research project of the Matukura Department of Surgery.
The studies also include inquiries into the fluctuations of the adrenocortical hormones and electrolytes, both maintaining a close relationship to the main problem.
The results obtained may be summarized as follows :
1. Antidiuretic substance in the blood of the hepatic artery and vein as well as of the portal vein is remarkably increased during the course of ileus.
2. Under normal condition as well as at the shock stage of ileus the tissues of the organs directly supplied by the portal vein, particulary of the intestinal canal are not significantly concerned with either the production or disposal of antidiuretic substance.
3. By estimating the difference in the content of serum antidiuretic substance present in the portal vein from that in the hepatic vein, and in the hepatic artery compared with that in the hepatic vein, the ability of the liver to directly inactivate antidiuretic substance is greatly diminished during the shock stage of ileus beyond that under normal conditions.
4. A negative correlation was clearly recognized between the concentration of serum antidiuretic substance and the excretion of urinary chemocorticoid during the shock stage of ileus.
5. The chemocorticoid content in the blood of the femoral vein, hepatic vein and artery, and the portal vein is remarkably reduced in ileus shock in each instance.
6. In clinical cases of ileus the concentration of antidiuretic substance indicates a hige value, but it approaches the normal range within 4-7 days after radical operations. On the contrary, the excretion of urinary chemocorticoid is generally low in amount, but returns to the normal level on the 2nd to 4th day postoperatively.
7. Although there seems to be no significant correlation between the concentration of serum antidiuretic substance and that of chloride in serum or urine during the shock stage of ileus, a clearly positive correlation is recognized between the former and Na and K of serum and urine.
8. The urinary volume gradually decreases with the lapse of time when the portion of intestine immediately below the point of obstruction is completly removed simultaneously with establishment of acute duodenal ileus, but the rate of decrement is greatly suppressed in comparison with that during acute duodenal ileus. Concomitantly, the concentration of antidiuretic substance shows a tendency to increase gradually, but this increase is markedly suppressed when compared with the increment during acute duodenal ileus, accompanied by definite prolongation of survival period.
(Author's abstract)

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