Role of Bile and Pancreatic Juice in Production of Esophageal Erosions and Anemia.

Abstract

The esophagi of cats were perfused with bile (including human or bile salt solns.),pancreatic juice, mixtures of the 2, and succus entericus collected from the dog. Esophagitis resulted from perfusions lasting from 3-8 hrs. in all instances except when succus entericus was perfused. Mixed bile and pancreatic juice from the dog caused the most, and dog pancreatic juice the least severe changes. Total diversion of bile, pancreatic juice, mixtures of the two, or succus entericus into the esophagus resulted in 8-14 days in severe esophagitis manifested by bleeding, linear erosions and occasional ulcers except in those dogs having succus enterians diverted into the esophages. Within 4-6 wks. a severe secondary anemia developed,associated with blood in the stool. The lowest hemoglobin value reached was 6.3 g. A total gastrectomy with esophago-duodenostomy produced enough regurgitation of bile and pancreatic juice into the esophagus to cause erosions. This suggests that in humans a Roux Y type of anastomosis should be done.