THE ROLE OF DIAFRAGMATIC LYMPHATIC ABSORPTION IN THE DEVELOPMENT OF BACTEREMIA DUE TO THE EXPERIMENTAL PERITONITIS AND ITS EFFECT ON PROGNOSIS

Abstract

In order to examine the role of diaphragmatic lymphatics in the formation of systemic effects of an intraperitoneal infection, an experimental model has been developed in which lymphatic absorbtion was blocked with fibrosis. In this study 60 Wistar-Albino rats were separated in three groups of 20 animals; Group 1 (control), Group 2 (peritonitis), Group 3 (lymphatic blockage + peritonitis). In 15 hours of experiment period mortality rate was observed. Peritoneal content and blood culture results were obtained. Diaphragmatic fibrosis were examined. in the study mortality rates were 0%, 45%, 70% in groups 1-2-3 respectively. The mortality rate between the two peritonitis group was statistically significant (p=0.015<0.05). Pathologic evaluation of diaphragmatic fibrosis in group 3 was shown (+++) in 16 animals, (++) in three and (+) in one. Aerobic bacterial culture of the peritoneal content was negative in Group 1 and positive in all animals of Groups 2 and 3. Blood culture results were negative in Group 1. Gram negative bacteremia was found 95% in Group 2 and 30% in Group 3. The difference between Group 2 and 3 was statistically significant (p=1.97x10^-5 <0.05). Despite the presence of equal time peritonitis in two groups, mortality and bacteremia rates were significantly low in the Group 3 (lymphatic blockage). These results suggest the important role of lymphatic absorption in systemic spread of an intraperitoneal infection and in the early period of the pathogenesis of the septicemia.