After studies on normal persons1 and on patients with acute diffuse hepatic parenchymal injury2 it was proposed that the utilization of intravenously injected sodium d-lactate be employed as a test of hepatic function.3 The test was used in differential diagnosis of jaundice due to extrahepatic biliary obstruction and jaundice due to hepatic parenchymal damage. When compared to other tests of hepatic function the sodium d-lactate tolerance test proved to be most helpful in differentiating the two types of jaundice.3
The present paper deals with further studies on the use of intravenously injected sodium d-lactate as a differential diagnostic test between obstructive and nonobstructive jaundice.
As previously indicated,4 the test is physiologically dependent on the ability of normally functioning hepatic cells to convert blood d-lactate into glycogen. The dextrorotatory form of lactic acid is the physiologically occurring isomer which is encountered as an intermediary in the carbohydrate cycle