Spreading organisms by peritoneal lavage

A Prospective Study of Operative Risk Factors in Perforated Duodenal Ulcers

“…As part of a concurrent randomized trial, definitive operations were chosen for patients who had chronic ulcers at exploration (large ulcer craters or marked pyloroduodenal deformity) and who had none of the following features: age over -70 years; preoperative shock (blood pressure below 100 mmHg); poorly controlled major medical illnesses (cardiorespiratory disease, renal failure, diabetes mellitus, and hepatic precoma); perforation of more than 24 hours duration; and severe peritoneal contamination (abscess formation or the inability to cleanse the peritoneal cavity of foreign particles or fibrin debris despite copious saline lavage). However, four patients who had either concomitant bleeding or pyloric stenosis underwent vagotomy with pyloroplasty, even though they were older than 70 years or presented more than 24 The following features possibly related to mortality or morbidity were examined prospectively in each patient; sex, age, length of chronic ulcer symptoms, duration of acute perforation, extent of peritoneal contamination, previous ulcer operations, chronicity of ulcer at surgery, preoperative shock, and concurrent medical illnesses. In order to assess risk factors when this surgical policy was observed, the above features were evaluated in the entire consecutive series of patients without regard to the type of operation.…”

Detection of Fibrinolytic and Elastase Activity Among Clinical Isolates of <i>Serratia Marcescen</i><i>s</i>

“…To date, little work has been done with respect to the host-parasite relationships of this particular microorganism [3,11,13,14,16,20,25,29,30,31,38], It has been known for a long time that S. marcescens strains elaborate pathobiologically powerful endotoxins which are capable of eliciting generalized Shwartzman reactions [1,6]. Very recently, Q uarles et al [24] demonstrated dialyzable toxic products (maximal molecular weight 15,000) produced by a strain of S. marcescens that had been maintained in an ingeniously conceived goat artificial kid ney fermentor system; it was shown that when the population of bacterial cells had exceeded lO'/ml, and when the cells had reached the stationary phase of growth, the experimental animals became toxemic, leukopenic, and developed fever.…”