盲嚢症候群 (Blind Loop Syndrome) についての実験的並びに臨床的研究

From my experience during 1963-1967 obvious steatorrhea was observed in 6 patients after entero-enterostomies using the method of I¹³¹ triolein test or analyzing fat content of feces in these patients.<BR>To elucidate ill effect of blind loop the following experiments were made in dogs:<BR>The test meal was consisted of 1000gm of dog food “Ken-L-Meal” manufactured by Quaker Oats Co. U. S. A., 2 gms of Cr20₃ and 50ml of soya-bean oil in mixture. The test meal was fed to dogs for 4 days and 4th day's feces was analyzed for its fat content and its Cr2O₃ content by the method of van de Kamer (fat) and by the method of Dansky-Hill (Cr₃O₃). Dogs were operated as follows;<BR>(Group 1) Small intestine one meter distal from the dudeno-jejunal flexure was anastomosed side-to-side to the end of the ileum. So the small intestine was short-circuited.<BR>(Group 2) The small intestine between one meter distal from the duodeno-jejunal flexure and the end of the ileum was resected.<BR>(Group 3) The small intestine forming the loop in group 1 was resected after about three months postoperatively.<BR>Results;<BR>1.Change of body weight; The dogs of group 1. lost their body weight gradually. On the contrary no body weight loss was observed in group 2.<BR>2.Fat content of the feces and fat absorption; The fat content of feces was 0.81gm/100 gm wet feces in normal dogs, 4.50gm/100 gm wet feces in dogs of group 1 and 2.62gm/100 gm wet feces in dogs of group 2 on an average. The fat absorption coefficient were 94.1% in normal dogs, 52.3% in dogs of group 1 and 86.4% in dogs of group 2 on an average.<BR>3.In autopsy and in surgery no remarkable stasis of intestinal content was observed.<BR>4.The villi of the intestine showed no remarkable change.<BR>There are recently some studies concerning the cause of steatorrhea, but its mechanism is not fully clear. From my experiments I think that steatorrhea in group 1 was not only due to short-circuiting of meals in the intestinal canal but also due to existence of blind loopitself. In other words the blind loop per se is an important factor causative of Steatorrhea.