Decompression of the small bowel in intestinal obstruction

Small intestinal intubation is an efficient method for relieving the harmful distention associated with intestinal obstruction and ileus. of obstruction as being strangulated unless this possibility can be excluded. We have found intubation particularly helpful in the treatment of paralytic ileus. Although one would think that with a paralyzed bowel there could be no onward progress of the tube, actually the tube does pass and the term paralytic must be considered a relative one. We have nearly always found sufficient muscular power remaining to allow resumption of peristalsis once the intestinal wall has been relieved of its overdistention. In cases of organic obstruction without strangulation the method will at times bring about the relief of the condition. In a larger group of cases, however, intubation simply prepares the patient for operation. By relief of distention the harmful effects of the obstruction are removed, the patient’s general strength is built up and he comes to have a more nearly normal fluid and chemical balance. Furthermore, the operative procedure is facilitated by the absence of distention and by the fact that the site of the obstruction has been localized. It must be clearly recognized that this method, however valuable it may be, is simply another adjunct to the methods for treating organic intestinal obstruction. Small intestinal intubation is not a procedure to be lightly undertaken. It necessitates infinite patience and attention to detail, and requires constant exercise of all the diagnostic acumen of those attending the patient, if the best results are to be attained on the one hand, and the dangers are to be avoided on the other. Above all. since intestinal obstruction remains a condition usually reauiring operation, it is our feeling that intubation whenever used, should be under The method has proven uniformly successful in relieving the distention seen in paralytic ileus. In organic obstruction it makes possible more efficient preparation of the patient for operation; it often localizes the point of obstruction and by overcoming distention makes things easier for the surgeon. The low mortality rate of 9.3 per cent indicates that when properly used the method is of decided value in the treatment of intestinal obstruction and paralytic ileus.