Bacteremia associated with operative decompression of a small bowel obstruction.
BACKGROUND
Intraoperative decompression of the small bowel has been advocated as a method of aiding recovery of both the patient and the intestine. However, the methods proposed (retrograde stripping or enterotomy) require vigorous handling of bacteria-laden small bowel, possibly giving rise to a bacteremia.


METHODS
A small bowel obstruction was created in 31 rats by means of a ligature. Twenty-four hours later, the obstruction was relieved, and the rats were divided into three groups: relief of obstruction alone, relief with retrograde stripping, and relief with enterotomy plus suction. Blood cultures were taken before and after manipulation of the bowel.


RESULTS
In blood cultures taken before and after manipulation there was a significant increase of Escherichia coli bacteremia in the two manipulation groups compared with the relief of obstruction only group.


CONCLUSIONS
Bacteremia may be an effect of operative decompression of obstructed bowel, which at times outweighs its supposed benefits.
Merrett
N D
ND
Department of Surgery, St. George Hospital, Sydney, Australia.
Jorgenson
J
J
Schwartz
P
P
Hunt
D R
DR
D000818:Animals; D016470:Bacteremia / Q000209:etiology* / Q000382:microbiology; D004927:Escherichia coli Infections / Q000209:etiology; D007415:Intestinal Obstruction / Q000601:surgery*; D007421:Intestine, Small / Q000382:microbiology / Q000601:surgery*; D011183:Postoperative Complications; D051381:Rats; D017207:Rats, Sprague-Dawley