Document Detail


Adverse effect of splenectomy in experimental peritonitis.
MedLine Citation:
PMID:  4010267     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients undergoing splenectomy have increased operative morbidity and mortality, especially when associated with gastrointestinal surgery or injury. This present study was designed to assess the effect of splenectomy on mortality in a polymicrobial fecal peritonitis model and evaluate therapy with antibiotic (cefoxitin) or immunomodulation (glucan). Human stool-barium (0.15 cc) was placed in the peritoneum of Sprague-Dawley rats at the time of splenectomy or sham surgery. Splenectomy animals were then treated with 5% dextrose, cefoxitin (60 mg im q 6 hr), glucan (7.5 mg ip prior to surgery), or cefoxitin plus glucan. Splenectomy resulted in decreased survival (5% vs 30%, P less than 0.05). Treatment with cefoxitin (90%) or glucan (47%) significantly improved survival. Combined glucan-cefoxitin therapy had no improvement over cefoxitin alone. Peritoneal and blood cultures were performed 12 hr postoperatively. There were no significant differences in growth of bacteria between sham and splenectomy animals. Cefoxitin treatment resulted in lower growth of bacteria from both blood and peritoneum (P less than 0.05). Glucan treatment caused a significant decrease in the number of bloodborne bacteria (P less than 0.05). Intravascular colloidal carbon clearance and leucocyte counts were performed at 12 hr postoperatively. Presence of peritonitis significantly enhanced intravascular clearance, while splenectomy had no effect. Addition of glucan or cefoxitin therapy to splenectomy animals did not enhance intravascular clearance. Leucocyte counts were significantly lower (P less than 0.05) when splenectomy was added to peritonitis animals. Glucan and cefoxitin therapy did not increase leucocyte counts. Based on these studies we conclude that (1) splenectomy increases mortality in fecal peritonitis, (2) antibiotic and immunomodulator afford some protection, and (3) exact mechanism of protection remains unclear.
Authors:
N Moustoukas; W Browder; C Gleason; N Di Luzio; R L Nichols
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of surgical research     Volume:  38     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  1985 Jun 
Date Detail:
Created Date:  1985-08-02     Completed Date:  1985-08-02     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  574-81     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adjuvants, Immunologic / pharmacology
Animals
Bacteria / growth & development
Cefoxitin / pharmacology
Glucans / pharmacology
Leukocyte Count
Male
Peritonitis / complications,  immunology*,  mortality
Phagocytosis / drug effects
Rats
Rats, Inbred Strains
Sepsis / etiology
Splenectomy / adverse effects*
Grant Support
ID/Acronym/Agency:
A-I-17974//PHS HHS
Chemical
Reg. No./Substance:
0/Adjuvants, Immunologic; 0/Glucans; 35607-66-0/Cefoxitin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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