Bacteriology and spectrophotometry of the peritoneal fluid in strangulation obstruction: Clinical studies

Abstract

Eighteen cases of suspected strangulation obstruction were studied during a two-year period in seven large Philadelphia hospitals. These represent all the cases made available for study during this time. Peritoneal fluid from these cases was submitted to bacteriologic and spectrophotometric study. Significant peritonea! fluid spectrophotometric pigment changes were absent in simple obstruction and in strangulation obstruction not requiring resection. Peritoneal fluid cultures were generally negative in simple obstruction. Peritoneal fluid cultures may be negative in strangulation obstruction not requiring resection. Positive spectrophotometric changes comparable to those in experimental work were observed in a single case of strangulation obstruction. Positive spectrophotometric changes in the peritoneal fluid were not consistent in true strangulation obstruction. Peritoneal fluid cultures were positive in a higher percentage of cases of true strangulation obstruction than in any other type of obstruction. Positive bacteriologic findings in the peritoneal fluid of any type of obstruction were associated with a more complicated postoperative course than negative bacteriologic findings. Positive spectrophotometric findings in a single clinical case establish the occurrence of such a pigment change in human strangulation obstruction, and make further evaluation of the pigment worthwhile.