Abstract
Whereas the importance of the early relief of mechanical ileus has been appreciated by all clinicians, there has been a controversy-concerning whether only a simple relief should be performed or whether in addition to relieving the obstruction the bowel should be emptied of its contents mechanically by “stripping ”the intestine. Even though, as shown by experimental and clinical investigations, 1 , 2 , 3 such a procedure produces marked trauma resulting in cardiovascular changes, the theoretical advantages of complete emptying of the intestine by mechanical “stripping ”consist of decompressing the intestine and relieving the strangulation of the intramural intestinal vessels.
In the present investigation the results obtained by simple relief of mechanical ileus were compared with those in which, in addition to the relief of the obstruction, a mechanical evacuation of the intra-intestinal contents was secured. Mechanical ileus wras produced in dogs and after varying periods of time (from 48 hours to 144 hours), the animal was relaparotomized under sterile precautions. In one series of animals the mechanical obstruction was relieved, whereas in a similar series in addition to the relief of the mechanical obstruction, the dilated loops of intestine were emptied of their contents by introducing a catheter into the bowel, and “stripping ”the intestine toward the enterostomy tube. The catheter was removed and the opening in the gut sutured. The abdominal wall was closed. After 24 hours, observations were made concerning the activity of the intestine. The animals were laparotomized, balloons were introduced into the lumen of the gut and kymographic tracings obtained as described previously. 4 To determine the intestinal activity, “hypertonic ”Hartmann's solution, which previously had been shown to exert a marked stimulating effect on intestine, 5 was administered intravenously to each animal and the intestinal activity recorded.
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