Gaseous distention results from bacterial growth in the stagnant contents of an obstructed bowel. This is sometimes the most dangerous factor in the entire process of intestinal obstruction. In 1898, Kocher1 emphasized the fact that gas pressure within the lumen alone may cause gangrene of the wall of the bowel. It is probable that numerous observers have noted the close relationship between distention and gangrene of the obstructed loop, but this important mechanism has received little experimental study.
Van Beuren,2 in observations on dogs with experimental ileus, found gross injury of the bowel, and usually beginning gangrene, within seventy-two hours after obstruction. He considered gaseous distention as the chief mechanism of this early necrosis, and described the process as follows:
The greater the distention of the intestine, the less the residual elasticity of its wall and the vessels in it. As for the vessels themselves, their elongation results
GATCH WD, TRUSLER HM, AYERS KD. EFFECTS OF GASEOUS DISTENTION ON OBSTRUCTED BOWEL: INCARCERATION OF INTESTINE BY GAS TRAPS. Arch Surg. 1927;14(6):1215–1221. doi:10.1001/archsurg.1927.01130180100006
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