The persistently poor results obtained by surgeons in acute intestinal obstruction are in a large measure due to delay in diagnosis. Clinicians have been disposed to place a good deal of reliance on the expulsion of an enema as evidence militating against the presence of mechanical obstruction in the bowel, and there exists a general unwillingness to accept the diagnosis of acute obstruction of the intestine as long as enemas continue to be returned with the expulsion of gas and feces.
In this study an attempt has been made to evaluate the significance of the expulsion of enemas as a criterion of intestinal obstruction.
In a series of nine dogs, obstructions of varying types were established, and Noble's enemas were subsequently administered. In four animals a high jejunal complete obstruction was established by severing the bowel and inverting the proximal end; the distal end was brought up and anchored to
WANGENSTEEN OH, GOEHL RO. EVALUATION OF THE EXPULSION OF ENEMAS AS A CRITERION OF INTESTINAL OBSTRUCTION. Arch Intern Med (Chic). 1930;46(4):669-679. doi:10.1001/archinte.1930.00140160119012