Experimental Low Colonic Obstruction.

Abstract

The evidence has been accumulating that one of the major factors in death from high intestinal obstruction is loss of fluid and chlorides. This does not signify that a toxemia of unknown nature is not important in such cases. For this reason we have studied a series of dogs with low colonic obstruction. Eleven dogs survived the operation and at autopsy showed no cause of death other than simple obstruction; in 5 of these, obstruction was produced by a band of gauze tied tightly about the rectum; in the remaining 6 the colon was severed about 8 inches above the anus and both ends closed with sutures. The average length of life in these 12 animals was 8 1/2 days, maximum 20 and minimum 5 days. Autopsies showed the large bowel much dilated, discolored, and filled with gas and fluid fecal material. The small bowel was also markedly distended for some distance above the ileo-cecal sphincter, and showed hemorrhagic areas in the lower portion. The gall bladder was usually dilated; peritoneal cavity clear and containing little or no free fluid.

Food and fluid were allowed ad lib. Some of the animals ate well up to a few days before death, others refused food from the time of operation until death occurred. The 2 showing longest survival periods (19 and 20 days) ate almost like normal animals. All of the animals vomited slightly, the amount depending upon the intake and increasing in the 48 hours prior to death. In no case was the vomiting abundant, as seen in high obstruction.

Plasma chlorides were followed in all animals. In only 2 was a significant fall observed; these animals lived 5 and 6 days, respectively, and vomited greater quantities than the others of the series.