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

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      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.
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