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[The immuno-microbiological characteristics of the small intestine and the translocation of the enteral microflora in acute intestinal obstruction].

The complex examination of 72 patients with acute ileus (AI) of nontumor nature with different severity of endotoxicosis was carried out. The study revealed that AI was accompanied by deep suppression of the immunosecretory and motor evacuatory function of the small intestine, as well as by its pronounced bacterial contamination, mainly due to the significant quantitative prevalence of Gram-negative microflora. The combination of these factors played the key role in the increase of the permeability of the enteric barrier for symbiotic microflora and its massive translocation from the intestinal tract to the internal organs of the body (peritoneal exudate, portal bed), which directly correlated with the severity of endotoxicosis in AI patients. The deficiency of the barrier function of the liver was accompanied by the penetration of infective agents into the general blood stream, thus causing the development of endotoxic shock in AI patients. The analysis of the results thus obtained made it possible to determine the main ways for the elimination of intestinogenic intoxication in AI; they should be aimed at the bacterial decontamination of the small intestine, the restoration of its motor evacuatory and protective barrier functions, the liquidation of portal and systemic bacteremia, the correction of the functional deficiency of the liver.

Acute Disease↗
PubMed1978

[Pathogenesis of paralytic intestinal obstruction in peritonitis].

The author believes that the vascular spasm does not play any part in the occurrence of functional ileus in peritonitis. Humoral factors, such as the loss of electrolytes and serotonin, which is of a specific mediatory effect upon the intestine in particular, are by far more important. It seems that some other humoral factors, e.g. bacterial toxins and endotoxins, formed during the inflammatory process, play their part too. The article is published for purposes of discussion in connection with the paper by Yu. L. Shal'kov. a coll. (Vestnik Khirurgii, 1976, N 4, p. 55).

Hemodynamics↗