Narrowing of Intestine from Contraction of Experimentally Produced,Fibrous Capsule

Abstract

The constrictive force of a capsule of young sterile fibrous tissue surrounding short segments of intestine was studied, as an extension of previous experiments in the contractibility of this tissue. 1 ,²

Twelve different segments of ileum, 3 in each of 4 dogs, were treated. Operation: The abdomen was opened under aseptic precautions, a loop of terminal ileum was delivered, and a side-to-side anastomosis was made between the limbs of the loop, so as to sidetrack about 40 cm. of the gut. Then the mesentery of the sidetracked portion was incised about 3 cm., parallel to and about .5 cm. from the gut, at 3 different sites about 10 cm. apart and no nearer to the anastomosis than 5 cm. No mesenteric vessels were injured. At one site, the gut with its attached bit of mesentery was wrapped once about with a strip of thin rubber dam 2.5 cm. wide and just long enough to reach loosely around. The opposed edges were sutured together. At another site, light, close-woven silk cloth was used in the same manner; and at the third, this kind of cloth, impregnated with collodion (to render it impervious to fibroblasts), was similarly used. The whole loop was wrapped in omentum, returned to the abdomen, and the abdomen was closed. Five to 20 days after operation, the dogs were killed and the loops were removed. The bowel at each enveloped site was injected, first, with water under a gradient of pressure, to determine the patency; second, with barium suspension under 20 cm. H₂O pressure, to portray by X-ray the outlines of the lumen; and, third, with formalin, for fixation and section.

The reactions to the different kinds of envelop were essentially the same: All tissues in contact with the foreign material developed a heavy fibrous coating. That part of the coat against the inner aspect of the envelop came from, and completely surrounded, the intestinal segment. A considerable amount of slightly turbid, sero-fibrinous fluid bathed the envelop within these walls.