The origin of purulent-septic complications in the obturation ileus

Keywords: experimental obturative ileus; purulent-septic complications; purulent enteritis; an acute ileus.

Abstract

Objective. To establish the origin of the purulent complications developing in obturative ileus in experiment.

Materials and methods. The experiment was conducted on 24 white rats of the Wistar line, in whom obturative ileus was simulated.

Results. The data about dynamical changes of the intestinal wall histostructure above the obstruction and concerning its seeding degree were obtained. In 12 h from the obstruction occurrence the destructive changes in intestinal wall, consisting of mucosal phlegmonous inflammation, occurr, while the bacterial seeding level of the intestinal wall raises from 104 CFU/g of the tissue (the initial) up to 1011 CFU/g. In 36 hours of the ileus persistence the purulent inflammation spreads on submucosal and muscular layers, and translocation of microflora into submucosal layer occurs, the level of microbial seeding of intestinal wall in these terms raises up to 1010-1011 CFU/g of the tissue.

Conclusion. Phlegmonous enteritis develops in durable persistence of obturative ileus in intestinal wall, localized above the obstruction. After elimination of obturative ileus, the intestinal lumen and abdominal cavity sanation the main origin of purulent complications persists in intestinal wall above the obstruction.

Author Biographies

T. I. Tamm, Kharkov Medical Academy of Postgraduate Education

Tamm Tamara I. – MD, DSci(Med), Professor
Chief department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education
197 pr. Moskovsky, 61037, Kharkiv, Ukraine
+38 (057) 7601166
tamm_ti@ukr.net
orcid.org/0000-0001-6372-2092

V. V. Nepomnyashchiy, Kharkov Medical Academy of Postgraduate Education

Nepomniashchyi Valentin V. – Candidate of Medical Sciences,
Ph.D (Medecine) Assistant professor
Kharkiv Medical Academy of Postgraduate Education, department of surgery and proctology
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail doktor.nep@gmail.com
E-mail ORCID ID 0000-0001-6262-6795

E. A. Shakalova, Kharkov Medical Academy of Postgraduate Education

Shakalova Elena A. – Candidate of Medical Sciences, Ph.D (Medecine)
Assistant professor
Kharkiv Medical Academy of Postgraduate Education, department of surgery and proctology
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail shakalova.helena@gmail.com
E-mail ORCID ID 0000-0003-3401-4278

References

Bohun EA. Profilaktyka hniino–septychnykh uskladnen u khvorykh na hostru neprokhidnist kyshechnyku. PhD [thesis]. Kharkiv, 2010; 24 s. [In Ukrainian].

Shishkina GA, Topuzov EG, Petryashev AV, Vlasov DA. Lechebnaya taktika pri kolorektalnom rake, oslozhnennom dekompensirovanny`m narusheniem kishechnoj neprokhodimosti i distalnym razryvom tolstoj kishki. Onkologicheskaya koloproktologiya.2016;6(4):31–7. doi: 10.17650/2220–3478–2016–6–4–31–37. [In Russian].

Zhulovchinov MU, Shalkov YuL. Intubacziya zheludochno–kishechnogo trakta: retrospektivnaya oczenka pokazanij i rezultatov. Vestnik KazNMU. 2013;(5):15–7. [In Russian].

Cormann V. Colon and Rectal Surgery. Philadelphia: Lippincott Wilkins; 2013. 526 p.

Cercenado E, Torroba L, Canton R, Martinez–Martinez L, Chaves F, Garcia–Rodriguez JA, et al. Multicenter study evaluating the role of enterococci in secondary bacterial peritonitis. J Clin Microbiol. 2010;48(2):456–9. doi:10.1128/JCM.01782–09.

Amelung FJ, Consten EC, Siersema PD, Tanis PJ. A population–based analysis of three treatment modalities for malignant obstruction of the proximal colon: acute resection versus stent or stoma as a bridge to surgery. Ann Surg Oncol. 2016;23(11):3660–8. doi: 10.1245/s10434–016–5247–7.

Nepomniashchyi VV. Mistse dekompresii kyshkivnyka dlia likuvannia khvorykh na hostru tovstokyshkovu neprokhidnist. Visnyk Vinnytskoho natsionalnoho medychnoho universytetu. 2019; 23(3):420–4. doi: 10.31393/reports-vnmedical-2019-23(3)-14. [In Ukrainian].

Dumont F, Goéré D, Honoré C, Elias D. Abdominal surgical emergencies in patients with advanced cancer. J Visc Surg. 2015;152(6 Suppl):91–6. doi: 10.1016/j.jviscsurg.2015.09.014.

Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, et al. Diagnosis and management of complicated intraabdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(2):133–64. doi: 10.1086/649554.

Published
2020-05-26
How to Cite
Tamm, T. I., Nepomnyashchiy, V. V., & Shakalova, E. A. (2020). The origin of purulent-septic complications in the obturation ileus. Klinicheskaia Khirurgiia, 87(1-2), 67-69. https://doi.org/10.26779/2522-1396.2020.1-2.67
Section
Experimental Investigations

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