ABSTRACT
Surgeons have learned through experience or research that the consequences of leaving nonviable bowel in situ may include continued tissue necrosis, perforation, abscessation, adhesion formation, obstruction, loss of intestinal function and motility, endotoxemia, peritonitis, and death. Even an experienced clinician may find that viability of intestine subjected to subtle ischemic changes is difficult to detect at the time of surgery. Rarely, an intestinal segment that appears normal after release of strangulation at surgery deteriorates because of undetected vascular thrombosis or reperfusion injury; such segments can be impossible to recognize.
