Hugh E. Stephenson

The Effect of Morphine, Demerol and Codeine on Serum Amylase Values in Man

Summary Neither morphine, Demerol or codeine causes elevated serum amylase values unless the pancreas is secreting when the analgesic is given. Such conditions exist in a patient up to 4 hours after a meal or with acute primary or secondary inflammation of the pancreas. Thus the interpretation applied to a serum amylase value need not be altered because an analgesic has been used.

Diatrizoate Absorption From the Intestine

To the Editor:— The appearance of diatrizoate in urine after oral administration can occur in patients with normal gastrointestinal tracts, intestinal obstruction, or gastrointestinal inflammatory disease, but we believe that this is quite uncommon. In studies using diatrizoate administered orally or by enema in nonselected cases, Rubin ( Arch Surg 80 :495-500, 1960) reports only one urogram in over 150 studies; Epstein ( Amer J Roent 78 :694-697, 1957) reports no urinary tract visualization in 30 cases, and Shehadi ( Amer J Roentgen 89 :741-751, 1963) observed renal excretion in only two patients in a series of over 1,500 cases (both patients had small intestinal obstruction). The occurrence of a pyelogram after oral diatrizoate in intestinal obstruction also is unusual. Lowman ( Surg Gynec Obstet 106 :567-572, 1958) reports on an unselected total of 50 patients with the problem of intestinal obstruction as a surgical emergency. He states that after diatrizoate administration orally or