Attention has been called repeatedly to the similarity between the symptoms of acute high intestinal obstruction and those of duodenal fistula. Without going into a detailed review of theories as to the cause of death after high intestinal obstruction, we may say that considerable evidence has been presented that the loss of the contents of the upper part of the intestine by vomiting is a most important, or the most important, factor. The fact that dogs with a duodenal fistula suffer a rapid drop in blood chlorides, dehydration, rise of carbon dioxide—combining power and death within a few days, as shown by Eisberg1 and by one of us,2 strongly suggests that the loss of duodenal fluid by vomiting is of prime significance.
Although the loss of pancreatic juice alone produces symptoms the same as or similar to those enumerated above, it cannot be stated as yet that this