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August 1964

Shock After Long-Loop Strangulation Obstruction

Author Affiliations

Associate Professor, Department of Surgery (Dr. Barnett).; From the Department of Surgery, University of Mississippi Medical Center.

Arch Surg. 1964;89(2):270-272. doi:10.1001/archsurg.1964.01320020034005

During the course of previous studies concerning the mechanisms and management of shock resulting from strangulation obstruction, it was observed that the pathophysiologic changes varied according to the length of the gangrenous segment of the bowel.1,2 When the blood pressure was allowed to drop to 40 mm Hg after venous strangulation of the lower one half of the small bowel, it was necessary to resect the involved bowel and to give blood in order to obtain a satisfactory survival rate. On the other hand, when a similar blood pressure level was observed after strangulation of an intermediate loop (the lower one fourth of the small bowel) it was necessary to give antibiotic along with blood and resection in order to reach an acceptable survival rate. When treatment was instituted at a blood pressure level of 40 mm Hg after strangulation of a 10 cm segment of small bowel, we

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