Alterations in small-bowel microflora in acute intestinal obstruction.

Small-bowel content was examined bacteriologically whilst fresh and after storage for 24, 48, and 72 h in a modified Stuart's medium. There was little alteration in the viable count of individual intestinal organisms. For accurate quantitative analysis, 0-3 ml of intestinal content was enough. Specimens of small-bowel content were obtained by needle aspiration, and a qualitative and quantitative study was made of the microflora of patients with acute intestinal obstruction and of a control group of patients. Results in the control group confirmed the findings of the results of intubation studies by other workers, that a quantitative gradient of aerobic and anaerobic organisms exists from jejunum to distal ileum. In acute small-bowel obstruction and acute large-bowel obstruction there was a loss of the normal gradient and an increase in the absolute numbers of organisms present; this was particularly marked for anaerobic organisms in large-bowel obstruction.