Symptomatic blind segment of intestine following side-to-side anastomosis of intestine; review of the literature and report of a case.

Although probably most surgeons prefer to establish continuity of the intestinal tract by end-to-end anastomosis after resection or division of the bowel, still a considerable number of surgeons continue to establish side-to-side anastomoses. In addition to the usual complications which may follow end-to-end anastomoses, side-to-side anastomoses may produce a series of complications if the proximal segment of the bowel distal to the anastomosis is excessive. Dilatation and hypertrophy of this segment may develop, resulting in a gradually enlarging pouch which may progress to ulceration and perforation. As early as 1906 Cannon and Murphy 1 observed, in cats, that the proximal segment of a side-to-side anastomosis failed to empty properly if a redundant segment were left beyond the site of anastomosis. Estes and Holm, 2 in 1932, and Pearce, 3 in 1937, using dogs, demonstrated that when peristalsis was towards the blind proximal segments of bowel distal to a side-to-side anastomosis,