Advertisement
Society of University Surgeons| Volume 52, ISSUE 1, P266-279, July 1962

Correlation between intraduodenal osmotic pressure changes and Cr51 blood volumes during induced dumping in men with normal stomachs

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Since new questions have been raised recently concerning the etiology of the dumping syndrome, a controlled study has been made of responses to intragastric and intraduodenal instillation of hyperosmolar solutions in healthy men with normal stomachs. After intragastric instillation of the concentrated solutions there were no significant changes in observed responses. However, after intraduodenal instillation in the same individuals under similar conditions, the characteristic intestinal and vasomotor manifestations of the dumping syndrome were induced in each subject. These were associated with a decrease in plasma volume and concomitant decline in the induced elevation of osmotic pressure of duodenal contents during the dumping period. These changes are consistent with a large shift of body water into the intestinal lumen. It can be concluded from this study that the dumping syndrome represents the body's responses to elevated osmotic pressure in the upper small gut and that the basic factor which initiates these complex responses in intubated normal patients and in those who have had pylorectomies is the rapid introduction of sufficient quantities of hyperosmolar materials into the upper small intestine.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Abbott W.O.
        • Karr W.G.
        • Glenn P.M.
        • Warren R.
        Intubation studies of the human small intestine. XIV. The absorption of glucose from the duodenum.
        Am. J. M. Sc. 1940; 200: 532
        • Abbott W.O.
        • Karr W.G.
        • Miller T.G.
        Intubation studies of the human small intestine. VII. Factors concerned in absorption of glucose from the jejunum and ileum.
        Am. J. Digest. Dis. & Nutrition. 1937; 4: 742
        • Clarke J.S.
        • Wimmer R.B.
        The relation between plasma volume fall and movement of fluid into the jejunum during dumping.
        Gastroenterology. 1961; 40: 803
        • Duthie H.L.
        • Irvine W.T.
        • Kerr J.W.
        Cardiovascular changes in the post-gastrectomy syndrome.
        Brit. J. Surg. 1959; 46: 350
        • Fisher J.A.
        • Taylor W.
        • Cannon J.A.
        The dumping syndrome: Correlations between its experimental production and clinical incidence.
        Surg. Gynec. & Obst. 1955; 100: 559
        • Guyton A.C.
        ed. 2. Textbook of medical physiology. W. B. Saunders Co.,, Philadelphia1961: 855
        • Heckler R.B.
        • Brooks J.R.
        • Hamlin III, J.T.
        • Haskins R.G.
        Evaluation of the autonomic nervous system response in patients with the dumping syndrome.
        in: S. Forum. 11. 1960: 318
        • Hinshaw D.B.
        • Joergenson E.J.
        • Davis H.A.
        • Stafford C.E.
        Peripheral blood flow and blood volume studies in dumping syndrome.
        A. M. A. Arch. Surg. 1957; 74: 686
        • Hunt J.N.
        The osmotic control of gastric emptying.
        Gastroenterology. 1961; 41: 49
        • Hunt J.N.
        • MacDonald I.
        • Spunell W.R.
        Gastric response to pectin meals of high osmotic pressure.
        J. Physiol. 1951; 115: 185
        • Hunt J.N.
        • Pathak J.D.
        The osmotic effects of some simple molecules and ions on gastric emptying.
        J. Physiol. 1960; 154: 254
        • Huse W.M.
        • Hinshaw D.B.
        Blood flow studies in the experimental dumping syndrome.
        in: S. Forum. 11. 1960: 316
        • Johnson L.P.
        • Jesseph J.E.
        Evidence for a humoral etiology of the dumping syndrome.
        in: S. Forum. 12. 1961: 316
        • Karr W.G.
        • Abbott W.O.
        • Hoffman O.D.
        • Miller T.G.
        Intubation studies of the human small intestine. XII. The concentration and movement of glucose solutions in the stomach and duodenum.
        Am. J. M. Sc. 1940; 200: 524
        • Lawrence Jr., W.
        • Khentigan A.
        • Hudock J.
        • Vanamee P.
        The effect of intraduodenal administration of hypertonic glucose solution on external pancreatic secretion.
        Surgery. 1961; 49: 666
        • Lawrence Jr., W.
        • Mathews D.H.
        A study of water “shifts” in experimental dumping syndrome.
        in: S. Forum. 10. 1959: 180
        • Leonard A.S.
        • Papermaster A.A.
        • Wangensteen O.H.
        Treatment of postgastrectomy dumping syndrome by hypnotic suggestion.
        J. A. M. A. 1957; 165: 1957
        • Liljedahl S.O.
        • Mattsson O.
        • Pernow B.
        • Wallensten S.
        Cineroentgenographic studies of gastrointestinal motility in healthy subjects and in patients with gastric or duodenal ulcer. With special reference to various methods of gastrectomy and the dumping syndrome.
        Acta. chir. scandinav. 1959; 117: 206
        • Machella T.E.
        Symposium on some of the aspects of peptic ulcer: The mechanism of the post-gastrectomy dumping syndrome. Gastroenterology. 14. 1950: 237
        • Mathews D.H.
        • Lawrence Jr., W.
        • Poppell J.W.
        • Vanamee P.
        • Randall H.T.
        Change in effective circulating volume during experimental dumping syndrome.
        Surgery. 1960; 48: 185
        • Miller T.G.
        Intestinal intubation.
        Cleveland Clin. Quart. 1949; 16: 68
        • Morris Jr., G.C.
        • Greenfield L.J.
        • Jordan Jr., G.L.
        • Peddie G.H.
        • Gordon J.R.
        • De Bakey M.E.
        Physiologic considerations in the dumping syndrome.
        Ann. Surg. 1959; 150: 90
        • O'Hara R.S.
        • Fox R.O.
        • Cole J.W.
        Serotonin release mediated by intraluminal sucrose solutions.
        in: S. Forum. 10. 1960: 214
        • Pena Yanez A.
        • Rico Irles J.
        • Descalzo C.
        • Samper R.
        • Oliver S.
        Experimental dumping syndrome in intact stomach: results and possible pathogenesis.
        Rev. españ. enferm. ap. digest. 1960; 19: 669
        • Pontes J.F.
        • Neves D.P.
        Adrenal stimulation in the dumping syndrome.
        Gastroenterology. 1953; 23: 431
        • Read R.C.
        • Swensen D.
        Blood pressure and osmolarity changes in the dumping syndrome.
        Surg. Gynec. & Obst. 1961; 112: 488
        • Roberts K.E.
        • Randall H.T.
        • Farr H.W.
        • Kidwell A.P.
        • McNeer G.P.
        • Pack G.T.
        Cardiovascular and blood volume alterations resulting from intrajejunal administration of hypertonic solutions to gastrectomized patients. The relationship of these changes to the dumping syndrome.
        Ann. Surg. 1954; 140: 631
        • Scott Jr., H.W.
        • Weidner M.G.
        • Shull H.J.
        • Bond A.G.
        The dumping syndrome. II. Further investigations of etiology in patients and experimental animals.
        Gastroenterology. 1959; 37: 194
        • White F.T.
        Change in effective circulating volume during experimental dumping syndrome.
        Surgery. 1960; 48 (Discussion of: Mathews et al.): 185
        • Waalkes T.P.
        The determination of serotonin (5-hydroxytryptamine) in human blood.
        J. Lab. & Clin. Med. 1959; 53: 824
        • Weidner M.G.
        • Bond A.G.
        • Gobbel W.G.
        • Nelson I.A.
        • Shull H.J.
        • Scott Jr., H.W.
        Dumping syndrome: Reproducibility of the clinical and laboratory phenomena in animals and normal and gastrectomized patients.
        in: S. Forum. 8. 1958: 198
        • Weidner M.G.
        • Scott Jr., H.W.
        • Bond A.G.
        • Shull H.J.
        The dumping syndrome. I. Studies in patients after gastric surgery.
        Gastroenterology. 1959; 37: 188
        • Weidner Jr., M.G.
        • Bond A.G.
        • Gobbel W.G.
        • Shull H.J.
        • Scott Jr., H.W.
        An experimental and clinical study of “dumping syndrome”.
        Bull. Soc. internat. chir. 1958; 17: 287