Lack of effect of bile in pathogenesis of secretion in mechanical small bowel obstruction.

In dogs, the principal lesion in the ileal mucosa above a mechanical obstruction is the induction of a secretory state in which there is a net loss of water and electrolytes into the intestinal lumen. The role of stagnated bile as a possible agent provoking this secretion was explored by ligating the common bile duct and diverting the bile by means of an anastomosis between the gall bladder and the ileum distal to the obstruction. 7 days after creation of an obstruction with bile diversion, the functional and morphological changes in the obstructed loop were almost identical to those occurring in animals with obstructions without bile diversion. The secretory response above the obstruction continued unabated, with levels of cAMP in the secreting mucosae lower than in control tissues. These results suggest: (a) that the secretion in the obstructed intestine is not influenced by the presence of bile, and (b) that this secretion may not be secondary to an increase in mucosal cAMP levels.