Hubungan Lama Obstruksi Usus, Warna dan Kejernihan Cairan Peritoneum dengan Kontaminasi Bakteri pada Hernia Inkarserata

Abstract

Incarcerated hernia is an acute abdominal case caused by bowel obstruction due to incarceration of hernia ring. An experimental study on animals proved that there was mucosal barrier damage after 4 hours of total bowel obstruction and total damage after 12 hours causing bacterial translocation. In order to determine contamination due to bacterial translocation in the hernia sac, culture was taken from the peritoneal fluid. A cross-sectional study in Dr. Hasan Sadikin Hospital Bandung was done during October 2009 to July 2010 to analyze the relationship between duration of obstruction, color and clarity of peritoneal fluid, and bacterial culture. There were 40 patients, 36 males and 4 females involved in this study. Mean incarceration time was 7 hours. There were 11 positive culture cases, mostly Staphylococcus species (27%). Statistical analysis with chi-square and multiple logistic regression test showed that there was correlation between duration of obstruction and color and clarity of peritoneal fluid with bacterial contamination (p=0.015, p=0.001) with prevalence ratio of >7 hours length obstruction was 3.63, but not with clarity (p=0.078). In this study we could not obtain exact cut-off time of bowel obstruction’s period with bacterial translocation because it did not follow the pathologic event. In conclusions, there is correlation between duration of obstruction, color and clarity of peritoneal fluid with bacterial contamination, but bacterial translocation can not be proven because only commensal bacteria of the skin was obtained from the culture.

Keywords

• Bacterial contamination
• color and clarity of peritoneal fluid
• duration of obstruction
• incarcerated hernia