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Bacteremia associated with operative decompression of a small bowel obstruction
N D Merrett1, J Jorgenson, P Schwartz
1Department of Surgery, St. George Hospital, Sydney, Australia.
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.
Study Design:
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.