Bacteremia associated with operative decompression of a small bowel obstruction

BACKGROUND: Intraoperative decompression of the small bowel has been advocated as a method of aiding recovery of both the patient and the intestine. However, the methods proposed (retrograde stripping or enterotomy) require vigorous handling of bacteria-laden small bowel, possibly giving rise to a bacteremia. STUDY DESIGN: A small bowel obstruction was created in 31 rats by means of a ligature. Twenty-four hours later, the obstruction was relieved, and the rats were divided into three groups: relief of obstruction alone, relief with retrograde stripping, and relief with enterotomy plus suction. Blood cultures were taken before and after manipulation of the bowel. RESULTS: In blood cultures taken before and after manipulation there was a significant increase of Escherichia coli bacteremia in the two manipulation groups compared with the relief of obstruction only group. CONCLUSIONS: Bacteremia may be an effect of operative decompression of obstructed bowel, which at times outweighs its supposed benefits.