BACTEREMIA ASSOCIATED WITH OPERATIVE DECOMPRESSION OF A SMALL-BOWEL OBSTRUCTION

BACKGROUND: Intraoperative decompression of the small bowel has been a dvocated as a method of aiding recovery of both the patient and the in testine. However, the methods proposed (retrograde stripping or entero tomy) require vigorous handling of bacteria-laden small bowel, possibl y giving rise to a bacteremia. STUDY DESIGN: A small bowel obstruction was created in 31 rats by means of a ligature. Twenty-four hours late r, 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 be fore and after manipulation of the bowel. RESULTS: In blood cultures t aken before and after manipulation there was a significant increase of Escherichia cell bacteremia in the two manipulation groups compared w ith 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.