The peritoneal fluid in strangulation obstruction: The role of the red blood cell and E. coli bacteria in producing toxicity

Abstract

Summary An extensive investigation of the lethal properties of peritoneal fluid obtained from dogs dying of experimental strangulation obstruction of the small intestine has been carried out. Similar studies were also carried out on fluid obtained from a human with strangulation obstruction. The rat was used as a recipient animal, and the results obtained were then confirmed in the dog. It was found that the toxicity of strangulation fluid appears to be due to the presence of a hemoglobin concentration greater than 1 gm, per cent and a level of {ulE. coli} of 10 7 organisms per milliliter or higher. These findings were true of strangulation fluid from a human as well as strangulation fluid obtained from dogs. Furthermore, it was found posible to create a fluid of similar toxicity and physiologic action by growing {ulE. coli} in nutrient broth containing whole blood or saline washed red blood cells. The major portion of the toxicity of the red blood cell appears to reside in the soluble fraction of hemolyzed cells rather than in the red cell stroma. It is felt that a further understanding of the manner in which the red blood cell or its constituents interfere with the normal defense mechanisms in the peritoneal cavity may shed additional light on the problem of host resistance as a whole.