scholarly journals INTESTINAL OBSTRUCTION

1919 ◽  
Vol 30 (2) ◽  
pp. 109-121 ◽  
Author(s):  
Lester R. Dragstedt ◽  
Carl A. Dragstedt ◽  
John T. McClintock ◽  
C. S. Chase
Keyword(s):  
Intestinal Obstruction ◽  
Blood Supply ◽  
Intestinal Mucosa ◽  
Alimentary Tract ◽  
Intestinal Bacteria ◽  
Acute Obstruction ◽  
Symptom Complex

1. It is impossible to sterilize the intestine by the use of chemical antiseptics even when these are applied directly to the mucosa of isolated segments. 2. The mucosa of the alimentary tract does not elaborate an internal secretion which is necessary to life, or a secretion which could be disturbed by the conditions of acute obstruction so as to account for the symptom complex of that condition. 3. The substances responsible for the toxemia in acute obstruction are produced by the action of intestinal bacteria on proteins or their split products. 4. An injury to the intestinal mucosa, particularly that resulting from disturbances of the blood supply to the intestine, greatly facilitates the absorption of these poisons. The work of Hartwell and his associates and that of Murphy and Brooks on this point are confirmed.

scholarly journals INTESTINAL OBSTRUCTION

1913 ◽  
Vol 17 (3) ◽  
pp. 286-306 ◽  
Author(s):  
G. H. Whipple ◽  
H. B. Stone ◽  
B. M. Bernheim
Keyword(s):  
Blood Pressure ◽  
Intestinal Obstruction ◽  
Intravenous Injection ◽  
Intestinal Mucosa ◽  
Closed Loop ◽  
Fatal Outcome ◽  
Toxic Substance ◽  
Protective Agent ◽  
Low Blood Pressure ◽  
Closed Duodenal Loop

Closed duodenal loops may be made in dogs by ligatures placed just below the pancreatic duct and just beyond the duodenojejunal junction, together with a posterior gastro-enterostomy. These closed duodenal loop dogs die with symptoms like those of patients suffering from volvulus or high intestinal obstruction. This duodenal loop may simulate closely a volvulus in which there has been no vascular disturbance. Dogs with closed duodenal loops which have been washed out carefully survive a little longer on the average than animals with unwashed loops. The duration of life in the first instance is one to three days, with an average of about forty-eight hours. The dogs usually lose considerable fluid by vomiting and diarrhea. A weak pulse, low blood pressure and temperature are usually conspicuous in the last stages. Autopsy shows more or less splanchnic congestion which may be most marked in the mucosa of the upper small intestine. The peritoneum is usually clear and the closed loop may be distended with thin fluid, or collapsed, and contain only a small amount of pasty brown material. The mucosa of the loop may show ulceration and even perforation, but in the majority of cases it is intact and exhibits only a moderate congestion. Simple intestinal obstruction added to a closed duodenal loop does not modify the result in any manner, but it may hasten the fatal outcome. The liver plays no essential role as a protective agent against this poison, for a dog with an Eck fistula may live three days with a closed loop. A normal dog reacts to intraportal injection and to intravenous injection of the toxic substance in an identical manner. Drainage of this loop under certain conditions may not interfere with the general health over a period of weeks or months. Excision of the part of the duodenum included in this loop causes no disturbance. The material from the closed duodenal loops contains no bile, pancreatic juice, gastric juice, or split products from the food. It can be formed in no other way than by the activity of the intestinal mucosa and the growth of the intestinal bacteria. This material after dilution, autolysis, sterilization, and filtration produces a characteristic effect when introduced intravenously. When in toxic doses it causes a profound drop in blood pressure, general collapse, drop in temperature, salivation, vomiting, and profuse diarrhea, which is often blood-stained. Splanchnic congestion is the conspicuous feature at autopsy and shows especially in the villi of the duodenal and jejunal mucosæ. Adrenalin, during this period of low blood pressure and splanchnic congestion, will cause the usual reaction when given intravenously, but applied locally or given intravenously it causes no bleaching of the engorged intestinal mucosa. Secretin is not found in the duodenal loop fluid, and the loop material does not influence the pancreatic secretion. Intraportal injection of the toxic material gives a reaction similar to intravenous injection. Intraperitoneal and subcutaneous injections produce a relatively slow reaction which closely resembles the picture seen in the closed duodenal loop dog. In both cases there is a relatively slow absorption, but the splanchnic congestion and other findings, though less intense, are present in both groups. There seems, therefore, to be no escape from the conclusion that a poisonous substance is formed in this closed duodenal loop which is absorbed from it and causes intoxication and death. Injection of this toxic substance into a normal dog gives intoxication and a reaction more intense but similar to that developing in a closed-loop dog.

scholarly journals INTESTINAL OBSTRUCTION

1917 ◽  
Vol 25 (3) ◽  
pp. 421-439 ◽  
Author(s):  
Lester R. Dragstedt ◽  
James J. Moorhead ◽  
Fred W. Burcky
Keyword(s):  
Intestinal Obstruction ◽  
Blood Supply ◽  
Abdominal Cavity ◽  
Duodenal Mucosa ◽  
Bacterial Activity ◽  
Jejunal Mucosa ◽  
Necrotic Tissue ◽  
Tissue Necrosis ◽  
Bacterial Products

1. Closed intestinal loops in which bacteria are first removed are compatible with life. 2. Closed intestinal loops in which bacteria are present but in which tissue necrosis is prevented, are compatible with life. 3. Closed aseptic intestinal loops in which the blood supply is completely occluded are compatible with life. 4. The normal secretions and bacterial products of the duodenum and jejunum are not sufficiently toxic to produce any symptoms when allowed to drain into the abdominal cavity. 5. Our results do not support the theory of Draper of a normal toxic secretion of the duodenal mucosa, neutralized by the jejunal mucosa, or the perverted secretion theory of Whipple. 6. Bacterial activity plus necrotic tissue, or the absorption of toxic products resulting from the action of putrefactive bacteria on necrotic tissue is the important factor in the rapid death in simple closed intestinal loops.

scholarly journals A case of volvulus of the small intestine during eight months of pregnancy

2021 ◽  
Vol 32 (8-9) ◽  
pp. 760-762
Author(s):  
V. N. Vasiliev
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Acute Obstruction ◽  
The Subject

Intestinal obstruction is one of the chapters of modern surgery, where not all questions have yet been clarified and developed, which can be seen at least from the fact that this topic is the subject of discussion at the congresses and does not leave the pages of the surgical press. One thing is certain that the therapy of acute obstruction is exclusively surgical.

Successes of surgical treatment of ileus

1934 ◽  
Vol 30 (1) ◽  
pp. 113-113
Author(s):  
I. Philipоwicz
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Intestinal Obstruction ◽  
Acute Obstruction

The author reviews 14 years of material on surgical treatment of intestinal obstruction. In 119 operations for acute obstruction the author had a mortality rate of 27.7%. In the last 5 years for 45 cases only 15.5% mortality rate was observed.

scholarly journals Immunocytochemical study of gastrintestinal endocrine cells in insectivorous bats (Mammalia: Chiroptera)

2008 ◽  
Vol 68 (3) ◽  
pp. 663-669 ◽  
Author(s):  
CM. Santos ◽  
AA. Nascimento ◽  
AL. Peracchi ◽  
A. Sales ◽  
JS. Mikalauskas ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Intestinal Mucosa ◽  
Relative Frequency ◽  
Endocrine Cells ◽  
Alimentary Tract ◽  
Regional Distribution ◽  
Immunocytochemical Study ◽  
Insectivorous Bats ◽  
Molossus Molossus

The regional distribution and relative frequency of endocrine cells in the stomach and intestine of Phyllostomidae: Lonchorhina aurita and Molossidae: Molossus molossus bats were studied immunohistochemically. Three types of immunoreactive (IR) endocrine cells - to serotonin (5-HT), gastrin (GAS) and enteroglucagon (GLUC) - were found in the gastric mucosa and four types of IR cells were identified in the intestinal mucosa. This study showed an interespecfic difference in the regional distribution and relative frequency of endocrine cells in the Chiropteran alimentary tract.

scholarly journals Intestinal mucosal lymphocytes in neonatal sepsis

2019 ◽  
Vol 64 (4) ◽  
pp. 52-59
Author(s):  
Kh. S. Khaertynov ◽  
V. A. Anokhin ◽  
G. R. Burganova ◽  
G. O. Pevnev ◽  
M. O. Mavlikeev ◽  
...  
Keyword(s):  
Mucous Membrane ◽  
Large Intestine ◽  
Intestinal Mucosa ◽  
Neonatal Sepsis ◽  
Morphological Changes ◽  
Intestinal Bacteria ◽  
Main Group ◽  
Control Group ◽  
Small Intestinal Mucosa ◽  
Cd4 Lymphocytes

We studied the autopsy material obtained from 7 children who died in the neonatal period in order to evaluate the composition of lymphocytes of the intestinal mucosa against the background of morphological changes in the tissues of the gastrointestinal tract in newborns with sepsis. The main group consisted of 4 children with neonatal sepsis, the control group – of 3 newborns who died from other causes. The research material included the specimen of the small and large intestine.Results. Small intestine: it was found that there were less CD4 + lymphocytes in the small intestinal mucosa in the group of children who died from neonatal sepsis in 75% of cases than in the control group, but this difference was not statistically significant (p=0.1). There were no differences in the number of CD8 + and CD20 + cells in the studied groups. Large intestine: the number of CD4 + lymphocytes of the mucous membrane of the colon was greater in the main group of children than in the control group (p=0.03). An increase in the number of CD4 + cells was registered in 3 of 4 cases of neonatal sepsis. The number of CD8+ and CD20+ lymphocytes in the studied groups was the same (р>0.05).Conclusion. The increase in T-lymphocytes CD4+ in the mucous membrane of the large intestine is probably connected with the antigenic stimulation of opportunistic intestinal bacteria. We found no morphological signs of the suppression of the cells of adaptive immunity associated with the intestinal mucosa. 

Возможности ультразвукового исследования в диагностике удвоений желудочно-кишечного тракта у детей

2019 ◽  
pp. 40-56
Keyword(s):  
Acute Pancreatitis ◽  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Emergency Surgery ◽  
Alimentary Tract ◽  
Meckel’S Diverticulum ◽  
Duplication Cyst ◽  
Meckel's Diverticulum

В статье представлен анализ диагностики удвоений желудочно-кишечного тракта по историям болезни хирургического отделения, отделения патологии новорожденных, 1-го инфекционного отделения для детей грудного возраста ГБУЗ ВО “Областная детская клиническая больница” (г. Владимир) за последние 13 лет (с 2005 по 2017 г.). Было изучено 6 случаев диагностики и лечения удвоений пищеварительного тракта. У всех пациентов имело место удвоение различных отделов кишечника. Всем детям в ходе обследования выполнялось ультразвуковое исследование. Проведенный анализ позволил выделить 5 вариантов ультразвукового изображения удвоения кишечника и связанных с ним осложнений: 1) ультразвуковая картина кисты брюшной полости (n = 2, 33,4%); 2) ультразвуковая картина кисты брюшной полости с признаками кишечной непроходимости (n = 1, 16,7%); 3) ультразвуковая картина кишечной непроходимости (n = 1, 16,7%); 4) ультразвуковая картина перитонита (n = 1, 16,7%); 5) ультразвуковая картина образования, сходного с дивертикулом Меккеля (n = 1, 16,7%). В статье приведен обзор литературы, посвященный этой редко встречающейся аномалии развития и трудностям ее дооперационной диагностики. Отмечено отсутствие специфической клинической картины как самой аномалии развития, так и ее осложнений, что затрудняет доопеарционную диагностику удвоений пищеварительного тракта. Этому же способствует многообразие форм и локализаций данной аномалии развития, что отражается в разнообразии клинической и ультразвуковой картины. Подробно обсуждены и обобщены различные варианты ультразвуковой картины на примере собственных наблюдений и обзора литературы. Ключевые слова: ультразвуковая диагностика, удвоения желудочно-кишечного тракта, кишечная непроходимость, кистозная форма удвоения, острый живот, острый аппендицит, острый панкреатит, дивертикул Меккеля, неотложная хирургия, дети, ultrasound, alimentary tract duplications, intestinal obstruction, duplication cyst, acute abdomen, acute appendicitis, acute pancreatitis, Meckel’s diverticulum, emergency surgery

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