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INTESTINAL OBSTRUCTION : I. A STUDY OF A TOXIC SUBSTANCE PRODUCED IN CLOSED DUODENAL LOOPS
G H Whipple1, H B Stone, B M Bernheim
1Hunterian Laboratory of Experimental Pathology, Johns Hopkins Medical School, Baltimore.
The Journal of Experimental Medicine
|October 30, 2009
Summary
A toxic substance formed in closed duodenal loops causes severe illness and death in dogs, mimicking intestinal obstruction. This substance, produced by intestinal bacteria and mucosa, leads to splanchnic congestion and systemic collapse.
Area of Science:
- Gastroenterology
- Toxicology
- Surgical Pathology
Background:
- Closed duodenal loops in dogs can induce symptoms similar to volvulus or high intestinal obstruction.
- These models are crucial for understanding the pathophysiology of intestinal obstruction and potential toxic effects.
Purpose of the Study:
- To investigate the physiological effects and toxicological properties of substances produced within experimentally created closed duodenal loops in dogs.
- To determine the origin and nature of the toxic agent responsible for the observed pathology.
Main Methods:
- Surgical creation of closed duodenal loops in dogs, with and without prior lavage.
- Administration of the isolated loop material via intravenous, intraportal, intraperitoneal, and subcutaneous routes in normal dogs.
- Detailed clinical observation, including vital signs and fluid loss.
- Post-mortem examination to assess splanchnic congestion and intestinal mucosal changes.
Main Results:
- Dogs with closed duodenal loops exhibited rapid decline, characterized by vomiting, diarrhea, hypotension, and hypothermia, leading to death within 1-3 days.
- Autopsy revealed significant splanchnic congestion, particularly in the duodenal and jejunal mucosa.
- The material within the loops, devoid of digestive secretions, was identified as a toxic substance produced by intestinal mucosa and bacteria.
- Injections of this toxic substance into normal dogs produced similar, albeit more intense, systemic effects.
Conclusions:
- A toxic substance is endogenously produced within closed duodenal loops, responsible for the observed intoxication and mortality.
- This toxic agent causes profound splanchnic congestion and systemic collapse, mimicking severe intestinal obstruction.
- The findings highlight the role of the intestinal microbiome and mucosa in generating harmful substances under specific conditions.
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