Stercoraceous perforation of the right colon.

We have reported a case of stercoraceous perforation of the right colon with peritonitis. Stercoraceous perforation should be considered in patients with an acute condition of the abdomen, radiologic evidence of a perforated viscus, and a long-standing history of constipation. The condition is rare and has a high mortality. The treatment of choice is always surgical.

Intestinal obstruction due to schistosomiasis.

We have described a patient with intestinal obstruction caused by schistosomiasis but closely resembling colon carcinoma. The cause, demography, pathologic characteristics, and clinical management of the disease caused by Schistosoma mansoni are reviewed.

A comparison of the open and closed methods of anastomosis for colostomy closure.

A transverse colostomy was performed in dogs and, later, closed by resection and anastomosis. Half the anastomoses were done by the open and half by the closed method. The anastomoses were evaluated by barium enema series and by gross and microscopic examination. All anastomoses functioned well, but barium enema series showed great variation in the lumina diameter. Results of histologic studies revealed evidence of more inflammation and reaction about the open method.

The time at which infected postoperative wounds demonstrate increased strength.

It was again shown in this study that laparotomy wounds purposely infected with a known inoculum of live gram-negative bacteria exhibited greater tensile strength than did those in the normal control group. The organisms used were Escherichia coli and Pseudomonas aeruginosa. The phenomenon was not present during the first ten days after wounding but was quite evident in wounds tested at 14 and 21 days. By histologic examination, there was evidence of much more new collagen in the wounds that exhibited increased strength.

A study of the critical bacterial inoculum to cause a stimulus to wound healing.

Results of previous work have shown that wounds infected with gram-negative bacteria may be stronger than uninfected wounds. The inoculum in these studies was about 2 X 10(7) organisms. Laparotomy wounds were swabbed with inocula of from 10(2) to 10(9) organisms, Escherichia coli. Only with inocula of 10(6) or greater were all parts of all wounds infected by gross inspection. All wounds inoculated with 10(7) organisms, or more, were significantly stronger than the wounds of the control group on the 14th day. A smaller inoculum--10(3) to 10(6)--also resulted in stronger wounds, but not consistently so.

Quantitation of local acidosis and hypoxia produced by infection.

Increased strength of healing incisions infected with E coli was demonstrated in this experiment. Efforts to measure respiratory gas tensions and pH in these incisions were unsuccessful. Therefore, these moieties were measured in normal and infected wound fluid contained in implanted wire cylinders. The wound fluid from infected cylinders was consistently more acidotic and had a lower pO2 and a higher pCO2 than fluid from unifected wound cylinders.

Accelerated healing in infected wounds.

The effect of a standardized infection of pure and mixed cultures of gram-negative bacteria and a gram-positive coccus was studied in laparotomy wounds of rats. The infections were significantly stronger than in the control group wounds in 14 of 15 comparisons. This increased strength could not be correlated with an increased wound content of collagen. Results of histologic studies showed a vigorous inflammatory response which probably was responsible for the increased strength. There was a suggestion in our data to support the concept that certain bacteria evoke the proper inflammatory response to result in stronger wounds, while others provoke too little or too much inflammation.

Effect of partial constriction of the superior mesenteric artery upon absorption of d-xylose, labeled triolein and labeled albumin.

Intestinal adsorption of triolein, Risa and d-xylose was determined before and after reduction of blood flow in the superior mesenteric artery. Absorption of d-xylose did not change, but absorption of triolein and Risa appeared to be slightly improved after arterial constriction, even if the artery was completely thrombosed. Enhancement in absorption of Risa and triolein was probably the result of extensive collateral formation around the constricted superior mesenteric artery.