Laparoscopy and septic dissemination caused by perioperative perforation of the occluded small bowel: an experimental study.
Based on the observation of septic shock and severe respiratory impairment in two patients subjected to laparoscopic surgery for small bowel occlusion, an experimental study was carried out in rabbits to evaluate the effect of intra-abdominal CO2 hyperpressure on massive bacterial spread. Increased bacterial access to the blood was observed as a result of the mechanical effect of the hyperpressure associated with the highly septic contents of the occluded bowel. The important risk of bacterial dissemination following accidental peroperative perforation requires extreme caution in the laparoscopic management of late occlusions of the small intestine.
Bustos
B
B
Department of Surgery, Valencia University Medical School, Spain.
Gómez-Ferrer
F
F
Balique
J G
JG
Porcheron
J
J
Gobernado
M
M
Cantón
E
E
D000818:Animals; D001201:Ascites / Q000382:microbiology; D001407:Bacillus / Q000502:physiology; D016470:Bacteremia / Q000382:microbiology; D018988:Bacterial Translocation; D001799:Blood Sedimentation; D002245:Carbon Dioxide; D003016:Clostridium perfringens / Q000502:physiology; D015169:Colony Count, Microbial; D016983:Enterococcus / Q000502:physiology; D004926:Escherichia coli / Q000502:physiology; D007327:Insufflation / Q000009:adverse effects; D007415:Intestinal Obstruction / Q000382:microbiology / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology* / Q000382:microbiology; D007421:Intestine, Small / Q000293:injuries*; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects*; D007964:Leukocytosis / Q000209:etiology; D007970:Leukopenia / Q000209:etiology; D008297:Male; D010529:Peritoneal Cavity / Q000382:microbiology; D011312:Pressure / Q000009:adverse effects; D011549:Pseudomonas / Q000502:physiology; D011817:Rabbits; D012307:Risk Factors; D012772:Shock, Septic / Q000209:etiology
D002245:Carbon Dioxide