INTESTINAL OBSTRUCTION: CONTINUED STUDIES

Additional evidence is accumulating that death caused by intestinal obstruction is due to toxins originating in the epithelium of the duodenum and its appendages. Duodenal transplantation is, therefore, a satisfactory method for the experimental study of the cause of death in obstruction. Rogere, and more recently Whipple and his associates, have laid special emphasis on a proteose from the duodenal region. Sweet and his associates have laid special stress on the pancreas. Dragstedt, Moor-head and Burcky, on the other hand, again take up the bacterial origin of this toxemia. Our continuation of the study of this interesting problem has centered on three phases — transplantation, proteose isolation and obstruction ratio. DUODENAL TRANSPLANTATION The entire duodenum with its outbuds, the pancreas and liver, are first separated from the alimentary canal (Fig. 1). The pyloric end of the segment and the stomach are occluded, the duodenum is anastomosed to the ileojejunum, and