Effect of Porto-Caval Shunt on Splanchnic Blood Flow in Hemorrhage

Abstract

Hypovolemic shock of the dogs is regularly accompanied by hemorrhagic necrosis of the intestinal epithelium. According to Lillehei et al., (1962), Seikurt (1970) and Lefler (1970) hemorrhagic enteritis appears to play an etiologic role in the shock state. Although the cause of the widespread intestinal damage is not yet clear, hemodynamic changes undoubtedly play a relevant role in its development. It was repeatedly shown (Fine, 1967; Lillehei et al., 1967; Bashour & McClelland, 1967) that blood flow through organs of the splanchnic area decreases considerably both in hemorrhagic and other forms of shock. Among possible etiologic factors, the long-lasting hypotension, the increased sympathetic activity (Chien & Hitzig, 1964; Fedina et al., 1965; Thämer et al. 1969) and, in dogs only, the constriction of the hepatic sphincters (Conn & Parsons, 1950; MacLean et al., 1956; Knisely et al., 1957) should be considered. However the precise role of the hepatic sphincters in initiating necrosis of the intestinal epithelium has not yet been established. In order to clarify their role we studied the effect of porto-caval shunt on the development of shock in anesthetized dogs.