消化吸収に関する実験的臨床的研究

第1報胃切除患者の消化吸収について

抄録

Three cases of the postgastrectomized secondary kwashiorkor syndrome were described in the previous reports. In this study, the author made inquiries about 678 gastrectomy patients. They were resected for benign gastric and duodenal disease, and 85% of them answered that their present condition were good. As the result of clinical investigation in 225 cases, there were no cases of severe malnutrition or hypoproteinemia as like as secondary kwashiorkor, but latent malnutritious condition was present because of decreased dietary in take, steatorrhea or decreased body weight.
Various absorption tests and pancreozymin-secretin test were done in gastrectomy patients the results in carbohydrate and protein absorption tests differed little from normal subjects, although fat absorption was slightly decreased. The values in pancreozyminsecretin test, volume of duodenal juice, bicarbonate concentration, amylase and lipase and trypsin activities were all higher than those of normal subjects.
This was thought that it depended on conpensatoric hyperfunction, but in fact the digestion and absorption were decreased for lack of pancreozymin-secretin stimulation or inadequate mixture of the bile and pancreatic juice to diet.
Comparing with gastectomy patients, secondary kwashiorkor patients showed normal absorption of carbohydrate, although reduction of fat and protein absorptions was present, and paticularly protein malabsorption were so servere that this was pointed out to be one of cause in the secondary malnutrition. Pancreozymin-secretin tests corresponded with the above mentioned absorption tests, except amylase test, but bicarbonate concentration, lipase and paticularly trypsin activities were severely decreased. It was thought that this severe malnutrition was resulted from pancreas injury following gastrectomy.