Electrolyte imbalance in postoperative obstructions at the gastrojejunal stoma

Abstract The failure of the stoma to function properly in the manner of gastric retention following gastrectomy in association with alkalosis and low plasma chloride is believed to be due to an abnormal loss of chloride and intracellular potassium. 31 The normal potassium gradient and its relation to cellular function in the upper secretory intestine is discussed. These facts have been confirmed by application of the principle of isotope dilution with studies using radioactive potassium and sodium. Therapy should be directed in replacing potassium slowly (2.0 to 3.0 gm. KCl per L. of 5 per cent glucose) and avoiding the injudicious use of saline. Hypoproteinemia and ascorbic acid deficiency if present should be corrected. Because of the increased frequency of this complication on the services of less experienced surgeons several technical surgical suggestions are offered as these were observed most commonly in the series studied.