BACKGROUND: Intraoperative decompression of the small bowel has been advocated as a method of aiding recovery of both the patient and the intestine. However, the methods proposed (retrograde stripping or enterotomy) require vigorous handling of bacteria-laden small bowel, possibly giving rise to a bacteremia. STUDY DESIGN: A small bowel obstruction was created in 31 rats by means of a ligature. Twenty-four hours later, the obstruction was relieved, and the rats were divided into three groups: relief of obstruction alone, relief with retrograde stripping, and relief with enterotomy plus suction. Blood cultures were taken before and after manipulation of the bowel. RESULTS: In blood cultures taken before and after manipulation there was a significant increase of Escherichia coli bacteremia in the two manipulation groups compared with the relief of obstruction only group. CONCLUSIONS: Bacteremia may be an effect of operative decompression of obstructed bowel, which at times outweighs its supposed benefits.
BACKGROUND: Intraoperative decompression of the small bowel has been advocated as a method of aiding recovery of both the patient and the intestine. However, the methods proposed (retrograde stripping or enterotomy) require vigorous handling of bacteria-laden small bowel, possibly giving rise to a bacteremia. STUDY DESIGN: A small bowel obstruction was created in 31 rats by means of a ligature. Twenty-four hours later, the obstruction was relieved, and the rats were divided into three groups: relief of obstruction alone, relief with retrograde stripping, and relief with enterotomy plus suction. Blood cultures were taken before and after manipulation of the bowel. RESULTS: In blood cultures taken before and after manipulation there was a significant increase of Escherichia coli bacteremia in the two manipulation groups compared with the relief of obstruction only group. CONCLUSIONS:Bacteremia may be an effect of operative decompression of obstructed bowel, which at times outweighs its supposed benefits.
Authors: Susanna K P Lau; Alan McNabb; Gibson K S Woo; Linda Hoang; Ami M Y Fung; Liliane M W Chung; Patrick C Y Woo; Kwok-Yung Yuen Journal: J Clin Microbiol Date: 2006-11-22 Impact factor: 5.948
Authors: Andreas Türler; Christoph Schnurr; Atsunori Nakao; Sandra Tögel; Beverley A Moore; Noriko Murase; Jörg C Kalff; Anthony J Bauer Journal: Ann Surg Date: 2007-05 Impact factor: 12.969