Display Settings:

Format

Send to:

Choose Destination
Zentralbl Chir. 1998;123(12):1328-33.

[Pathophysiology of ileus].

[Article in German]

Author information

  • 1Abtl. für Viszeral- und Gefässchirurgie, Stauferklinik Schwäbisch Gmünd.

Abstract

OBJECTIVE:

To review the endogenous alterations generating critical illness in bowel obstruction.

DATA SOURCES:

Own experimental and clinical investigations and relevant articles published in international literature.

DATA SYNTHESIS AND CONCLUSIONS:

Large bowel obstruction is mostly confined to the colon. Passive dilatation and increasing luminal pressure might cause local gut wall ischemia with impending perforation whereas hypovolemia is not actively induced. Mediators are not released. Bacterial translocation occurs with little clinical significance. High small bowel obstruction with quantitative reflux predominantly causes early and marked hypovolemia and electrolyte disorders. In low small bowel obstruction the bowel wall is reacting upon the abundant luminal proliferation of gram-negative endobacteria: Induction of mucosal hypersecretion is the main cause of hypovolemia. Systemic endotoxinemia beginning with the fourth postobstruction day induces a septic inflammatory response encouraging organ failure. Systemic prostacyclin liberation in long standing obstruction or following intraoperative manipulation might generate cardiopulmonary decompensation.

PMID:
10063540
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Write to the Help Desk