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Altered motility and duration of bacterial overgrowth in experimental blind loop syndrome.

To better understand the pathogenesis of the increased motility previously described in the blind loop rat, we studied the relationship between duration of bacterial overgrowth and both myoelectric activity and bacterial flora in this model. Myoelectric studies and quantitative bacterial cultures were performed on self-filling and self-emptying (control) blind loop rats one, two, and three weeks postoperatively. All self-filling blind loop rats had greater random action potential activity and higher frequencies of migrating action potential complexes than controls (P less than 0.05). One-week self-filling blind loop rats had a higher frequency of migrating action potential complexes (P less than 0.05) and a higher ratio of counts of Escherichia coli to Bacteroides species (P less than 0.05) than the two- or three-week self-filling blind loop groups. Thus, qualitative changes in myoelectric activity occur during the development of bacterial overgrowth in the blind loop rat which may reflect evolving alterations in the bacterial flora.

Action Potentials↗

Intestinal blind pouch- and blind loop- syndrome in children operated previously for congenital duodenal obstruction.

A follow-up study of 27 children operated for congenital duodenal obstruction (CDO) in the years 1953--71 is presented. Nine children belonged to the intrinsic and 18 children to the extrinsic group of CDO. A total of 7 retrocolic, isoperistaltic, side-to-side duodeno-jejunostomy, 7 Ladd's operation, 8 duodenolysis, 2 reduction of midgut volvulus, 2 duodenostomy a.m. Morton and one gastro-jejunostomy were performed at the age of 1 day--15 years. The clinical and radiological examinations were performed 3--21 years (mean 10 years 2 months) after these operations. In 3 cases there was a moderate duodenal dilatation, but reoperation was not necessary. During the follow-up period, one boy, now aged 8 years, developed a blind pouch-syndrome in the I portion of the duodenum containing a 5 x 5 cm phytobezoar 4 1/2 years after duodeno-jejunostomy. The frequency of blind pouch-syndrome after duodeno-jejunostomy was thus 1:7 or 14%. One girl, now aged 9 years, developed a blind loop-syndrome in the ileocaecal segment 3 months after side-to-side ileotransversostomy, which was performed from adhesion-obstruction after duodenolysis for malrotation I and CDO. Both the blind pouch- and the blind loop-deformation were resected and the children recovered well. To avoid blind-pouch- and blind loop-deformations in the intestines, the anastomosis must be made wide enough, and especially in the surgery of the jejuno-ileo-colic region an end-to-end anastomosis is preferable.

Bezoars↗