Viability of the intestine.

Abstract

The margin of safety has not been definitely determined concerning circulatory changes in a segment of intestine as the result of injury, thrombosis, embolism or mechanical intestinal obstruction. The work of Rydigier 1 closely followed by that of Madelung 2 showed that it was impossible to establish any definite rule as to which vessels of the mesentery of the small intestine could be ligated without danger of gangrene. The experiments of Mall and Welch 3 brought out the fact that necrosis occurred if much more than 5 cm. of intestine were separated from its blood vessels.

This report is based upon the observations in twenty-four dogs. The circulation to an intestinal segment in each experiment was interfered with by ligation of various vessels in different portions of the intestine. The results obtained were as follows:

From the data herein presented it appears that the circulation returns to a segment of gut when three contiguous vessels are tied, or when the cecal branch of the ileo-colic is tied, or after other experimental ligations, as represented in table. The circulation, however, does not return when the main artery is ligated, or more than one vessel of the first arcade, or more than four contiguous terminal arteries.