One important clinical and experimental observation has long been accepted, namely, that acute obstruction in the proximal small bowel, duodenum or jejunum is more rapidly followed by serious symptoms and death than acute obstruction lower down, in the ileum or the colon. This has been variously explained. It has seemed possible to various workers that in addition to other possible factors, this might be correlated with the susceptibility of the wall of the bowel to interference with its circulation by the distention usually resulting from the obstruction. Some years ago, we1 stated:
Organs, such as the colon or stomach, which have in part a storage function are capable of very great distention without injury by reason of the arrangement of their blood supply. On the other hand, the small intestine, especially the duodenum, is capable of practically no dilatation. By reason of its investment in a tough, fibrous envelope
DRAGSTEDT CA, LANG VF, MILLET RF. THE RELATIVE EFFECTS OF DISTENTION ON DIFFERENT PORTIONS OF THE INTESTINE. Arch Surg. 1929;18(6):2257–2263. doi:10.1001/archsurg.1929.01140150021003
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