Simple intestinal obstruction causes bacterial translocation in man

E. A. Deitch
Department of Surgery, Louisiana State University (LSU) Medical Center, Shreveport 71130-3932.

Indirect clinical evidence has accumulated indicating that the gut may be a reservoir for microorganisms causing systemic infection in man. Our experimental results, in a variety of animal models, demonstrate that bacteria can translocate across the mucosal barrier and cause systemic infections. To determine directly whether bacterial translocation occurs in man, we cultured mesenteric lymph nodes (MLNs) obtained at laparotomy from 42 patients, none of whom were clinically infected. Ten (59%) of 17 patients with intestinal obstruction (none of whom had necrotic bowel) had bacteria in their MLNs, in contrast to one (4%) of 25 patients operated on for other reasons. The most common bacteria cultured from the MLNs was Escherichia coli. Thus, it appeared that simple intestinal obstruction of the colon or small bowel in the absence of necrotic bowel was associated with bacterial translocation.

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