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Article: Endotoxemia associated with intussusception and its diagnostic and surgical interventions

TitleEndotoxemia associated with intussusception and its diagnostic and surgical interventions
Authors
Issue Date2002
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00383/index.htm
Citation
Pediatric Surgery International, 2002, v. 18 n. 8, p. 685-688 How to Cite?
AbstractTo determine if and when intussusception results in endotoxemia and to evaluate whether diagnostic and surgical interventions of intussusception aggravate endotoxemia, intussusception was created in seven pigs during general anesthesia (ileocolic n = 3, ileo-ileocolic n = 2, ileocolic with silicone ring as leadpoint n = 1, ileoileal with silicone ring n = 1). After a period of observation and before progression to bowel gangrene, a diagnostic ultrasound study with a saline enema was undertaken, followed by a laparotomy and resection of the intussusception with a primary bowel anastomosis. Serial blood samples were obtained before and at regular intervals after: (1) formation of the intussusception; (2) the enema; and (3) resection for endotoxin measurement by limulus amebocyte lysate assay. The mean level of endotoxin increased from a pre-intussusception value of 0.750 EU/ml (range: 0.215-1.281) to a post-intussusception maximum of 1.482 EU/ml (0.997-2.882, P = 0.009), peaking mostly at 2 h after the intussusception. The mean pre-saline-enema level was 1.547 EU/ml (0.869-2.677) while the post-enema level was 1.41 EU/ml (0.84-2.468, P = 0.655). The mean pre-resection level was 1.470 EU/ml (0.784-2.468) while the post-resection maximum was (2.130 EU/ml) (0.850-4.381, P = 0.09). It is concluded that: (1) even in the absence of bowel gangrene intussusception results in significant endotoxemia within 2 h of its formation; (2) gentle saline enemas are not associated with endotoxemia; and (3) surgical resection results in a further upward surge of endotoxemia. These findings provide a scientific basis for improved understanding and management of intussusception.
Persistent Identifierhttp://hdl.handle.net/10722/88777
ISSN
2015 Impact Factor: 1.01
2015 SCImago Journal Rankings: 0.409
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, KLen_HK
dc.contributor.authorChan, JKYen_HK
dc.contributor.authorPeh, WCGen_HK
dc.contributor.authorChan, KWen_HK
dc.contributor.authorTam, PKHen_HK
dc.date.accessioned2010-09-06T09:47:51Z-
dc.date.available2010-09-06T09:47:51Z-
dc.date.issued2002en_HK
dc.identifier.citationPediatric Surgery International, 2002, v. 18 n. 8, p. 685-688en_HK
dc.identifier.issn0179-0358en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88777-
dc.description.abstractTo determine if and when intussusception results in endotoxemia and to evaluate whether diagnostic and surgical interventions of intussusception aggravate endotoxemia, intussusception was created in seven pigs during general anesthesia (ileocolic n = 3, ileo-ileocolic n = 2, ileocolic with silicone ring as leadpoint n = 1, ileoileal with silicone ring n = 1). After a period of observation and before progression to bowel gangrene, a diagnostic ultrasound study with a saline enema was undertaken, followed by a laparotomy and resection of the intussusception with a primary bowel anastomosis. Serial blood samples were obtained before and at regular intervals after: (1) formation of the intussusception; (2) the enema; and (3) resection for endotoxin measurement by limulus amebocyte lysate assay. The mean level of endotoxin increased from a pre-intussusception value of 0.750 EU/ml (range: 0.215-1.281) to a post-intussusception maximum of 1.482 EU/ml (0.997-2.882, P = 0.009), peaking mostly at 2 h after the intussusception. The mean pre-saline-enema level was 1.547 EU/ml (0.869-2.677) while the post-enema level was 1.41 EU/ml (0.84-2.468, P = 0.655). The mean pre-resection level was 1.470 EU/ml (0.784-2.468) while the post-resection maximum was (2.130 EU/ml) (0.850-4.381, P = 0.09). It is concluded that: (1) even in the absence of bowel gangrene intussusception results in significant endotoxemia within 2 h of its formation; (2) gentle saline enemas are not associated with endotoxemia; and (3) surgical resection results in a further upward surge of endotoxemia. These findings provide a scientific basis for improved understanding and management of intussusception.en_HK
dc.languageengen_HK
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00383/index.htmen_HK
dc.relation.ispartofPediatric Surgery Internationalen_HK
dc.subject.meshAnimalsen_HK
dc.subject.meshEndotoxemia - etiologyen_HK
dc.subject.meshEnemaen_HK
dc.subject.meshIntussusception - complications - surgery - ultrasonographyen_HK
dc.subject.meshStatistics, Nonparametricen_HK
dc.subject.meshSwineen_HK
dc.subject.meshUltrasonography, Doppler, Coloren_HK
dc.titleEndotoxemia associated with intussusception and its diagnostic and surgical interventionsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0179-0358&volume=18&spage=685&epage=688&date=2002&atitle=Endotoxemia+associated+with+intussusception+and+its+diagnostic+and+surgical+interventionsen_HK
dc.identifier.emailChan, KW:hrmtckw@hku.hken_HK
dc.identifier.emailTam, PKH:paultam@hkucc.hku.hken_HK
dc.identifier.authorityChan, KW=rp00330en_HK
dc.identifier.authorityTam, PKH=rp00060en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid12598964-
dc.identifier.scopuseid_2-s2.0-0036920140en_HK
dc.identifier.hkuros79265en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036920140&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume18en_HK
dc.identifier.issue8en_HK
dc.identifier.spage685en_HK
dc.identifier.epage688en_HK
dc.identifier.isiWOS:000181679200009-
dc.publisher.placeGermanyen_HK

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