A Mechanical Impediment to Intestinal Flow

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Abstract
MASSIVE MASSIVE RESECTION of the small intestine may cause severe nutritional deficiencies which will not respond to diet or drug therapy. Because of this fact, patients who need massive resection, such as those with extensive regional enteritis, mesenteric vascular occlusion, intra-abdominal neoplasm, and so on, may be denied resection. Various surgical procedures designed to improve nutrition after massive resection have been studied in animals. These procedures have in common the objective of delaying the passage of food through the short segment of remaining intestine to prolong contact between food and mucosa.1In this regard the action of the ileocecal junction may be duplicated.1,2The reversed intestinal segment has been evaluated by Hammer et al,3Singleton et al,4and the authors. A serious disadvantage of the reversed segment, in our experience, is the narrow margin which exists between a beneficial delay in transit which is within a

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