title: Portal and systemic endotoxemia in abdominal operations: the significance of acute abdomen.
abstract: Little evidence is available for the implication of bacterial translocation in cases of acute abdomen. Intraoperative endotoxemia in both portal and systemic circulation was studied in 20 surgical patients with acute abdomen and in 36 controls undergoing elective abdominal surgery. Blood was sampled simultaneously from a mesenteric vein immediately after opening the peritoneum and from a peripheral vein. Endotoxin was measured by a colorimetric Limulus amebocyte lysate assay and malondialdehyde (MDA) was measured by the thiobarbiturate assay and passage through a high-performance liquid chromatography (HPLC) system as a marker of the oxidative status. LPS concentrations (mean +/- SE) in portal vein blood from patients with acute abdomen was 5.69 +/- 1.58 and from patients with chronic diseases 1.05 +/- 0.07 EU/ml (P < 0.0001). Respective values for the systemic circulation were 4.98 +/- 1.47 and 1.36 +/- 0.31 EU/ml (P < 0.0001). Concentrations of MDA (mean +/- SE) in portal vein blood from patients with acute abdomen was 11.16 +/- 4.00 and from patients with chronic diseases was 10.56 +/- 2.39 mum (P NS). Positive correlations were observed between endotoxin and MDA in both portal and systemic circulation. These results indicate increased levels of endotoxin in acute abdominal conditions pointing to the gut as the site of origin of the bacterial products.
authors.affiliation: 4th Department of Internal Medicine, University of Athens, Medical School, Haidari, Greece. dplach@med.uoa.gr
authors.forename: Diamantis
authors.initials: D
authors.lastname: Plachouras
authors.forename: Michalis
authors.initials: M
authors.lastname: Stamatakos
authors.forename: Fotini
authors.initials: F
authors.lastname: Baziaka
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giamarellos-Bourboulis
authors.forename: Thomas
authors.initials: T
authors.lastname: Tsaganos
authors.forename: Helen
authors.initials: H
authors.lastname: Giamarellou
authors.forename: Michalis
authors.initials: M
authors.lastname: Safioleas
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000006:Abdomen, Acute / Q000382:microbiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018988:Bacterial Translocation; D019446:Endotoxemia / Q000209:etiology*; D005260:Female; D006801:Humans; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D011169:Portal Vein; D011446:Prospective Studies
chemical_list: D008070:Lipopolysaccharides; D008315:Malondialdehyde