Dynamic Aspects of Small Intestinal Rupture With Special Consideration of Anastomotic Strength

Abstract

THE INTRINSIC resistance of the gut to rupture from intraluminal pressure increase is of importance to surgeons from several points of view, particularly when considered in relation to the strength of healing anastomoses. The pattern of events in the healing process in general is well documented in reviews.^1,2,3 Healing of intestinal anastomoses has been studied in some detail and tends to follow a characteristic pattern. Sandblom³ and Harvey and Howes⁴ reported that the healing intestinal wound has an initial lag period during which it has no intrinsic strength. Each day thereafter there was a rapid increase in strength up to the tenth day, at which time the wound was as strong as normal bowel. Harvey's⁵ data indicate a strength of 50% to 60% of eventual maximum on the seventh day. Only Sandblom gives credit to Chlumsky⁶ for his pioneering work on the strength of