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Mechanisms of gastric bleeding under obstructive jaundice were studied in adult male Wistar rats. Following ligation of the common bile duct, mucosal noradrenaline significantly decreased in both the pyloric and fundic gland areas of the gastric mucosa by 20 days after the operation. Serotonin increased only in the pyloric gland area, and histamine increased in the fundic gland area. Urinary excretion of free noradrenaline significantly increased after the ligation. Three weeks after the ligation, restraint and water immersion experiments were conducted. Under water immersion, gastric blood flow significantly reduced in rats with obstructive jaundice compared to controls. Acid output decreased in both groups. Gastric bleeding was noted in the fundic gland area significantly earlier in the ligated rats than in the non-ligated rats. Administration of noradrenaline s.c. 30 minutes before immersion significantly blocked the reduction in gastric blood flow and protected the gastric mucosa against acute bleeding under immersion. These results suggested that prolonged obstructive jaundice may deplete noradrenaline in the gastric mucosa, and that gastric mucosal ischemia caused by this sympathetic dysfunction plays an important role in the formation of acute gastric bleeding under obstructive jaundice.
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