Shock in Bile Peritonitis. ∗

Conclusions

Intraperitoneal or intravenous injections of bile or of sodium glycocholate produce the shock syndrome characteristically in dogs. This is accompanied by hemo-concentration as in shock otherwise produced. Sublethal degrees of shock follow sublethal doses of the agents mentioned. These may recover or may result in pulmonary edema, pneumonia and subsequent death. The postmortem findings are the same as those following shock otherwise produced. These are: marked capillary and venous engorgement of the lungs, serosa, gastro-intestinal mucosa, liver and kidneys; edema of lungs, gastro-intestinal mucosa, and serous effusions; anemia of the splenic substance. The evidence indicates that bile or its salts cause acute injury to the walls of capillaries and venules. This results in atony and increased permeability, whereby a disparity develops between blood volume and volume-capacity of the vascular system. Such a disparity manifests itself in the shock syndrome.