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December 20, 1930


Author Affiliations


JAMA. 1930;95(25):1903-1907. doi:10.1001/jama.1930.02720250025007

The most important single factor in the clinical consideration of acute intestinal obstruction is the element of time; a second one of great moment is offered by the site and character of the obstruction, whether high or low, the former pursuing a more rapidly fatal course than the latter. The precise significance of these two factors becomes apparent with a full realization of the sequence of events common to all types of acute intestinal obstruction; namely, mechanical obstruction of the intestine with stoppage of the fecal current, damage to the bowel wall with ultimate gangrene and peritonitis, and an associated production of toxins often of the most virulent type. The high mortality that has obtained and still obtains in the treatment of intestinal obstruction is a serious indictment of both diagnostic ability and surgical initiative.

A study of accumulated statistics reveals what is common knowledge, to wit, that, while acute

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