The Relative Effects of Distention on Different Portions of the Intestine

Dragstedt, Carl A.

doi:10.1001/archsurg.1929.01140150021003

Cited by 62 publications

(7 citation statements)

References 5 publications

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“…Eisberg (1925) showed that in the small intestine of the dog the vasa recta pierce the muscularis shortly after leaving the mesentery, while in the large intestine they pierce the muscularis nearer the antimesenteric border. Dragstedt et al (1929) confirmed this work and showed that the vessels pierce the muscularis in the duodenum even earlier than in the jejunum. They accordingly suggest that the longer the vessels remain superficial in the wall of the bowel the better is it able to withstand distension.…”

supporting

confidence: 77%

“…Cause of Death.-The duodenal infarction may be explained by the work of Dragstedt et al (1929), who showed that the duodenum in the dog is more vulnerable to infarction from raised intraluminal pressure than any other part of the intestine. Eisberg (1925) showed that in the small intestine of the dog the vasa recta pierce the muscularis shortly after leaving the mesentery, while in the large intestine they pierce the muscularis nearer the antimesenteric border.…”

mentioning

confidence: 99%

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Acute Distension of Afferent Loop after Polya Gastrectomy

Watson¹

1958

BMJ

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Acute distension of the afferent loop is a rare complication of Polya gastrectomy which has always been attributed to an organic obstruction at the stoma. In some cases the nature of the obstruction has been clearly demonstrated. Thus, acute angulation at the stoma may arise from displacement of the afferent loop either behind the efferent loop (Quinn and Gifford, 1950) or in front of it (West, 1953), or from volvulus of the anastomosis (Hoyte et al., 1957).In the few reported cases which have arisen in the early post-operative period the cause of the distension has not been so convincingly shown

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supporting

confidence: 77%

mentioning

confidence: 99%

Acute Distension of Afferent Loop after Polya Gastrectomy

Watson¹

1958

BMJ

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“…These data also demonstrate that diminution of mesenteric perfusion inhibits excretion of Hz by the respiratory pathway, which accounts for elimination of 14% of total He production in human adults (I 2). Intraluminal distention has been previously shown to interfere with intestinal blood flow (8). It is possible that impedance of HZ transport from the intestinal lumen may further compromise the mesenteric circulation in infants with low flow states.…”

Section: Discussionmentioning

confidence: 99%

Breath Hydrogen Reflects Canine Intestinal Ischemia

et al. 1981

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SummaryThe relationship between breath hydrogen excretion and intestinal ischemia was investigated in nine mechanically ventilated dogs under pentobarbital anesthesia. An ileal segment was isolated in situ, ligated a t each end, and insufflated with hydrogen. Expired air was collected at intervals. Blood volume was reduced 30% by three successive equivalent hemorrhages 10 min apart. Local bowel ischemia was produced by clamping the blood supply to the isolated segment for 10 min. Graded hemorrhage produced stepwise reductions in breath hydrogen concentration, to 77 + 13, 66 -t-15, and 35 f 8% (mean f S.E.) of baseline after the first, second, and third hemorrhages, respectively. These reductions correlated highly (r = 0.84; P < 0.01) with declines in mean aortic blood pressure. Occlusion of blood supply caused a significant ( P < 0.025) decrease in breath hydrogen concentration and excretion to 39 k 14% of baseline. Termination of occlusion was followed within 2 min by a 7-fold increase in breath Hz concentration above the original baseline, probably reflecting reactive hyperemia. Breath hydrogen measurements appear to reflect functional (hemorrhagic shock-induced) and mechanical (vascular occlusion induced) enteric ischemia in dogs. SpeculationMonitoring of breath Hz excretion in the infant at risk for necrotizing enterocolitis may indicate the development of enteric hypoperfusion. Inhibition of transfer of Hz into the portal circulation in the presence of reduced mesenteric blood flow may contribute to distention of the bowel in necrotizing enterocolitis and further impede intestinal perfusion.Exhaled hydrogen (H2) is an accurate, noninvasive index of intestinal carbohydrate malabsorption, (6,12,13,17,18,20). Hz in breath is the product of: (1) incomplete absorption of sugar substrate; (2) intraluminal fermentation of substrate by enteric flora yielding Hz; (3) transfer of Hz into the portal circulation; (4) perfusion of the lungs resulting in diffusion of HZ into the air spaces; and (5) excretion of HZ from the alveoli. Although the availability of carbohydrate and bacteria governs production of Hz, the transfer of Hz from the intestinal lumen to the lung appears to be dependent on circulatory factors. By fitting absorption parameters for inert gases to models of interaction between perfusion and diffusion, Levitt and Levitt (14) demonstrated that the rate of absorption of HZ from the intestine is primarily a function of intestinal blood flow, being only marginally affected by diffusion. Enteric perfusion being the rate-limiting step in absorption of hydrogen, changes in intestinal blood flow sufficient to produce ischemia should be reflected in breath Hp excretion. The purpose of the present study was to determine the effects of functional (hemorrhagic shock-induced) and mechanical (vascular occlusioninduced) reduction in intestinal perfusion on Hp excretion in breath. MATERIALS AND METHODS PREPARATION OF INTESTINAL SEGMENTSTransfer of Hz from the intestinal lumen to alveolar air was measured using closed i...

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“…The question has come under consideration in many con¬ nections throughout the fields of physiology and clinical medicine. One generally learns from textbooks that hemosiderin is relatively insoluble and therefore is only slowly removed from the seat of formation, so that it may be found at the site of a hemorrhage after the other 1 evidences of blood extravasation have disappeared. After a time it may be taken away and deposited in the liver or spleen.…”

mentioning

confidence: 99%

Hemosiderin

1929

JAMA

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The Relative Effects of Distention on Different Portions of the Intestine

Cited by 62 publications

References 5 publications

Acute Distension of Afferent Loop after Polya Gastrectomy

Acute Distension of Afferent Loop after Polya Gastrectomy

Breath Hydrogen Reflects Canine Intestinal Ischemia

Hemosiderin

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