title: Does large-bowel enema reduce septic complications in acute pancreatitis?
abstract: BACKGROUND
  The source of septic complications in acute pancreatitis was unknown until recent years. The pathogenesis of bacterial translocation from the gut has been accepted as the main source of pancreatic or peripancreatic infection. This study was designed to investigate the role of large bowel enema during acute pancreatitis in preventing bacterial translocation.
  
  
  METHODS
  Twenty-four Spraque-Dawley rats were used in this study. The rats were divided into two groups. Group I animals received biliopancreatic duct ligation plus colon cleansing by rectal enemas; group II animals received only biliopancreatic duct ligation. Rectal enemas were applied to the first group of animals three times, at 6, 24, and 48 hours after the operation using 10 cc sodium hydrogen phosphate solutions. All animals were sacrificed 72 hours later, and tissue samples were taken from mesenteric lymph nodes, pancreas, spleen, and liver for bacteriologic cultures via a midline laparatomy. Blood and cecum cultures were also prepared.
  
  
  RESULTS
  Positive mesenteric lymph node cultures were found in all 12 animals in group II but in only 3 of 11 animals of group I (P <0.05). Distant organ cultures were positive in 9 of group II, but the only infected distant organ culture found in group I was the positive liver culture (P <0.05).
  
  
  CONCLUSIONS
  As a result of this study, we believe that large bowel enema can reduce the frequency of septic complications in acute pancreatitis by reducing bacterial translocation.
authors.affiliation: Department of General Surgery, University of Selçuk, School of Medicine, Konya, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Sahin
authors.forename: S
authors.initials: S
authors.lastname: Yol
authors.forename: E
authors.initials: E
authors.lastname: Ciftçi
authors.forename: M
authors.initials: M
authors.lastname: Baykan
authors.forename: S
authors.initials: S
authors.lastname: Ozer
authors.forename: M
authors.initials: M
authors.lastname: Aköz
authors.forename: O
authors.initials: O
authors.lastname: Yilmaz
authors.forename: C
authors.initials: C
authors.lastname: Kuru
mesh_terms: D000208:Acute Disease; D000818:Animals; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D001419:Bacteria / Q000302:isolation & purification; D018988:Bacterial Translocation; D002432:Cecum / Q000382:microbiology; D003106:Colon; D004733:Enema; D008099:Liver / Q000382:microbiology; D008198:Lymph Nodes / Q000382:microbiology; D008643:Mesentery; D010179:Pancreas / Q000382:microbiology; D010195:Pancreatitis / Q000150:complications*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013154:Spleen / Q000382:microbiology; D016896:Treatment Outcome