[Experimental study on the development of endotoxemia in peritonitis with special reference to route of absorption of...

As endotoxemia develops and presents marked symptoms in severe peritonitis, the absorption route of endotoxin from the peritoneal cavity was studied in this study. Twenty-four adult mongrel dogs were divided into 4 groups as follows. Group 1: Physiological saline solution was injected intraperitoneally with thoracic duct (TD) lymph drainage. Group 2: Peritonitis was induced without lymph drainage. Group 3: Peritonitis was induced with TD lymph drainage. Group 4: Peritonitis was induced with right lymph duct (RLD) and TD lymph drainage. Peritonitis was induced by intraperitoneal injection of endotoxin (Difco 055 B5 LPS) at 0.5 mg/kg. In Group 4, the endotoxin level in lymph from RLD reached a maximum value of 4.19 X 10(7) +/- 2.32 X 10(7) pg/ml (mean +/- S.E.), while that from TD was only 7203 +/- 5022 pg/ml. The endotoxin level in the portal venous blood three hours after administration was almost within normal limits throughout the experiment. In conclusion the route of endotoxin absorption in peritonitis is considered to be via the lymphatic system and in particular RLD is assumed to play an important role.