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. 1983 Nov;198(5):596–600. doi: 10.1097/00000658-198311000-00006

Inhibition of upper gastrointestinal secretions by reinfusion of succus entericus into the distal small bowel. A clinical study of 30 patients with peritonitis and temporary enterostomy.

E Lévy, D L Palmer, P Frileux, R Parc, C Huguet, J Loygue
PMCID: PMC1353130  PMID: 6416191

Abstract

We prospectively studied peritonitis secondary to small bowel leakage in 30 critically ill patients, each of whom had complete diversion of intestinal continuity by stoma, fistula, or both. All patients received total parenteral nutrition during implementation of the protocol. The proximal intestinal effluent was collected and recycled into the distal small bowel. During reinfusion of succus entericus, a significant reduction in the output of the proximal stoma was observed (mean 30.2%, p less than 0.001). The reinfusion also significantly reduced the volume from isolated small bowel loops in six patients (32.6%, p less than 0.001). When isotonic dialysate solution was infused into the distal intestine, a lesser though significant reduction in stoma output occurred (mean 20.3%, p less than 0.001). These findings demonstrate a consistent inhibitory effect upon upper gastrointestinal secretions by reinfusion of succus entericus. Clinical benefits of this technique include simplified control of fluid and electrolyte balance in patients with high output stomas and optimal utilization of remaining absorptive capacity for enteral nutrition.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Clain J. E., Go V. L., Malagelada J. R. Inhibitory role of the distal small intestine on the gastric secretory response to meals in man. Gastroenterology. 1978 Apr;74(4):704–707. [PubMed] [Google Scholar]
  2. Clain J. E., Malagelada J. R., Go V. L., Summerskill W. H. Participation of the jejunum and ileum in postprandial gastric secretion in man. Gastroenterology. 1977 Aug;73(2):211–214. [PubMed] [Google Scholar]
  3. Duffy P. A., Granger D. N., Taylor A. E. Intestinal secretion induced by volume expansion in the dog. Gastroenterology. 1978 Sep;75(3):413–418. [PubMed] [Google Scholar]
  4. Goligher J. C. Resection with exteriorization in the management of faecal fistulas originating in the small intestine. Br J Surg. 1971 Mar;58(3):163–167. doi: 10.1002/bjs.1800580303. [DOI] [PubMed] [Google Scholar]
  5. Hawley P. R., Faulk W. P., Hunt T. K., Dunphy J. E. Collagenase activity in the gastro-intestinal tract. Br J Surg. 1970 Dec;57(12):896–900. doi: 10.1002/bjs.1800571206. [DOI] [PubMed] [Google Scholar]
  6. Hawley P. R., Hunt T. K., Dumphy J. E. Etiology of colonic anastomotic leaks. Proc R Soc Med. 1970;63 (Suppl):28–30. [PMC free article] [PubMed] [Google Scholar]
  7. Humphreys M. H., Earley L. E. The mechanism of decreased intestinal sodium and water absorption after acute volume expansion in the rat. J Clin Invest. 1971 Nov;50(11):2355–2367. doi: 10.1172/JCI106734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. LANDOR J. H., BAKER W. K. GASTRIC HYPERSECRETION PRODUCED BY MASSIVE SMALL BOWEL RESECTION IN DOGS. J Surg Res. 1964 Nov;4:518–522. doi: 10.1016/s0022-4804(64)80023-8. [DOI] [PubMed] [Google Scholar]
  9. Levy E., Cosnes J., Loygue J. Rétro-action négative sur le débit sécrétoire digestif de la réinstillation continue du suc digestif dans des entérostomies temporaires artificielles et pathologiques. C R Seances Acad Sci D. 1979 Feb 5;288(5):509–511. [PubMed] [Google Scholar]
  10. Lévy E., Parc R., Loygue L., Loygue J. Stomies terminales, jéjunales ou iléales temporaires de sauvetage avec réinstillation autorégulée. Nouv Presse Med. 1977 Feb 12;6(6):461–462. [PubMed] [Google Scholar]
  11. Osborne M. P., Frederick P. L., Sizer J. S., Blair D., Cole P., Thum W. Mechanism of gastric hypersecretion following massive intestinal resection. Clinical and experimental observations. Ann Surg. 1966 Oct;164(4):622–634. doi: 10.1097/00000658-196610000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Saik R. P., Copeland E. M., Miller L. D., Smith G. P. Effect of ileal exclusion on the Heidenhain pouch acid response to histamine in dogs. Ann Surg. 1971 Jan;173(1):67–77. doi: 10.1097/00000658-197101000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Santillana M., Wise L., Schuck M., Ballinger W. F., 2nd Changes in gastric acid secretion following resection or exclusion of different segments of the small intestine. Surgery. 1969 May;65(5):777–782. [PubMed] [Google Scholar]

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