J.Jpn. Surg. Soc.. 62(6): 568-592, 1961
EXPERIMENTAL STUDIES OF THE INTESTINAL OBSTRUCTION AND ITS REMOVAL, ESPECIALLY ON EXTRA-INTESTINAL BACTERIA
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Department of Surgery, Nihon Medical College (Director: Prof. Kiyoshi SAITO) Shisei SUZUKI |
The similar experiments were carried out also on the groups which were given extensive antibiotic therapy and which received intestinal resektion lower than the obstructed portion in addition to high intestinal obstruction. The following results were obtained:
1) No bacterium was found in the liver, spleen and peritoneal cavity of the normal healthy dogs. A few gram-positive bacteria were observed in the portal vein blood in 15.4% of the dogs, which were exterminated completely with the administration of antibiotics. In half of the dogs, a small number of bacteria which derived from the intestinal canal were present in the mesenteric lymphnodes. These were not affected by the use of antibiotics.
2) Only a few bacteria seemed to reach the liver or spleen hematogenously, lymphogenously or through the peritoneal cavity during intestinal obstruction, while a number of bacteria were found in the mesenteric lymphnodes very frequently. The bacteria in the mesenteric lymphnodes amounted to a considerable number transiently after the removal of high obstruction. In the case of low obstruction, the bacteria in the mesenteric lymphnodes increased makedly when the obstruction lasted more than 72 hours, but promptly decreased after the removal of obstruction.
No bacterium was observed in the peritoneanl cavity when the obstruction was high, while a few appeared occasionally after its removal. The completely reverse result was found when the obstruction was low.
3) The chemotherapy diminished markedly the number of bacteria. Especially after the removal of obstructon, an almost aseptic condition was observed in the chemotherapy group, differing remarkably from the control group. However, as to the bacteria in the mesenteric lymphnodes, there was no such significant difference between the chemotherapy group and the control group. Thus, the effect of chemotherapy was not remarkable on the bacteria in the lymphnodes.
4) The bacteria isolated from the liver, spleen and portal vein blood were usually the same kind in an individual. This result indicates the close relation between these organs. They were mostly gram-positive micrococci, and gram-negative bacteria were found only in a few cases. The kinds of bacteria in these organs were not changed by the production of intestinal obstruction or by its removal.
5) The bacteria isolated from the mesenteric lymphnodes, escherichiae occupied a great portion during high obstruction and gradually were replaced with other kinds of bacteria after its removal.
In low obstruction, escherichiae were always dominant. When the duration of obstruction was prolonged and after its removal, the kinds of bacteria showed a marked variety. The administration of chemotherapy did not produce such a remarkable change.
6) When the intestinal resection was performed at the lower portion than the obstruction, in addition to high intestinal obstruction, the extra-intestine remained aseptic or in almost normal condition. It suggests that mainly the bacteria in the small intestine lower than the obstructed portion move outside the intestinal canal during high obstruction.
(Author's abstract)
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