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February 1957

Symptomatic Blind Segment of Intestine Following Side-to-Side Anastomosis of Intestine: Review of the Literature and Report of a Case

Author Affiliations

Fort Wayne, Ind.

AMA Arch Surg. 1957;74(2):273-275. doi:10.1001/archsurg.1957.01280080127020

Although probably most surgeons prefer to establish continuity of the intestinal tract by end-to-end anastomosis after resection or division of the bowel, still a considerable number of surgeons continue to establish side-to-side anastomoses. In addition to the usual complications which may follow end-to-end anastomoses, side-to-side anastomoses may produce a series of complications if the proximal segment of the bowel distal to the anastomosis is excessive. Dilatation and hypertrophy of this segment may develop, resulting in a gradually enlarging pouch which may progress to ulceration and perforation.

As early as 1906 Cannon and Murphy1 observed, in cats, that the proximal segment of a side-to-side anastomosis failed to empty properly if a redundant segment were left beyond the site of anastomosis. Estes and Holm,2 in 1932, and Pearce,3 in 1937, using dogs, demonstrated that when peristalsis was towards the blind proximal segments of bowel distal to a side-to-side anastomosis,

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