STUDIES ON MECHANISMS OF BIOCHEMICAL UNBALANCE FOLLOWING URETEROCOLIC ANASTOMOSIS

Abstract

In one patient who suffered from urethrorectal fistula and in another who had his right and left ureter transplanted, respectively, into sigmoid and to skin, the urine obtained from the bowel and bladder or ureter was chemically analyzed. In one dog with an isolated distal colon the chemistry of saline solution instilled into the rectum was studied.
The results obtained were as follows:
The reabsorption of sodium, potassium, ammonia and chloride from the bowel, particularly the higher reabsorption of chloride than the fixed base, was potent in the disturbance of the normal regulation of the constancy of the internal environment.
Evidence of increased demand on the kidney function was our finding that the bladder urine was very acid.
In the exchange between CI^- and HCO^-₃ in the colonic mucosa, which might be a cause of increased loss of body alkali, there resulted an increase of bicarbonate concentrations, a higher pH and an excessive loss of chloride in the bowel urine.
The reabsorption of sodium from the bowel exceeded that of the chloride and the amount of bicarbonate in the bowel urine decreased when the extremly alkaline urine following the administration of diamox passed into the colon.