Changes in the Blood Resulting From Duodenal Fistula

Attention has recently been directed to duodenal fistulas by Colp, 1 Cameron 2 and Rigby, 3 who have compiled and carefully summarized data on reported cases. However, no definite explanation of the cause of death in such cases has been given. Believing that the chemical changes in the blood accompanying clinical and experimental duodenal fistula might afford information of value, we made a study of these at the Mayo Clinic. Two patients with acute postoperative duodenal fistula, one following gastric resection for carcinoma with a posterior Polya type of anastomosis, the other resulting from the removal of an abdominal sponge, were studied, as well as some sixty dogs in which fistulas had been produced experimentally. The chemical changes in the blood associated with both clinical and experimental acute duodenal fistula are similar to those reported by Haden and Orr, 4 Brown, Eusterman, Hartman and Rowntree, 5 and McVicar 6 in