Pathogenic aspects of stomach ulcerogenesis in acute intestinal obstruction

Close metadata

Aim. To identify the patterns and the correlation of morphological and functional changes in stomach wall with the dynamics of different types of acute intestinal obstruction. Material and methods. The study was performed on 33 adult mongrel dogs of both genders weighing 17—20 kg. All researches were conducted in accordance with the documents, such as the «Guide for the Care and Use of laboratory animals of the National Institute of Health (National Institute of Health — NIH, Bethesda, USA)» and «Rules of work with experimental animals». The same methods were used to study the morphology of stomach wall in normal conditions and after intestinal obstruction simulation. We used H & E stain, Van Gieson’s picrofuchsin staining combined with Mallory. The choice of histochemical methods was determined by the need to study metabolic processes in epithelial cells and gastric mucosa glands. Einarson method for detecting total nucleic acids was used. The last group of methods was statistical analysis. Results. We determined the regularities of structural organization of microcirculation in various parts of the stomach, the correlation of morphological and functional changes in stomach wall with the dynamics of different types of acute intestinal obstruction. Conclusion. Our data indicate proximal-distal gradient of gastric perfusion: the most pronounced vascular network and maximum blood flow are observed in proximal stomach in both normal conditions and acute intestinal obstruction. More tenuous and reduced blood flow was revealed in the antrum, that is morphological basis of the most frequent localization of acute ulcers in this department.

Keywords:

acute intestinal obstruction

small intestine

stomach

acute ulcers

Authors:

Miliukov V.E.

Kafedra khirurgii Gosudarstvennogo instituta usovershenstvovaniia vracheĭ Ministerstva oborony RF, Moskva - kafedra anatomii cheloveka Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova

Nguen K.K.

Kafedra anatomii cheloveka Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova

List of references:

Ermolov A.S. Sostoyanie neotlozhnoi pomoshchi pri ostrykh khirurgicheskikh zabolevaniyakh organov bryushnoi polosti v lechebno-profilakticheskikh uchrezhdeniyakh Moskvy i mery po ee sovershenstvovaniyu. Khirurg. 2011;8:4-10.
Boland GM, Weigel RJ. Formation and prevention of postoperative abdominal adhesions. J Surg Res. 2006;132:3-12.
Lazarenko V.A., Lipatov V.A., Sotnikov A.S. i dr. Sovremennaya semiotika ostroi spaechnoi kishechnoi neprokhodimosti. Vestnik eksperimental'noi i klinicheskoi khirurgii. 2012;V:2:291-295.
Diaz JJJr, Bokhari F, Mowery NT, Acosta JA, Block EF, Bromberg WJ, Collier BR, Cullinane DC, Dwyer KM, Griffen MM, Mayberry JC, Jerome R. Guidelines for management of small bowel obstruction. J Trauma. 2008;64(6):1651-1664.
Fevang BT, Fevang J, Lie SA, Søreide O, Svanes K, Viste A. Long-term prognosis after operation for adhesive small bowel obstruction. Ann Surg. 2004;240(2):193-201.
Kössi J, Salminen P, Rantala A, Laato M. Population-based study of the surgical workload and economic impact of bowel obstruction caused by postoperative adhesions. Br J Surg. 2003;90:1441-1444.
Vrijland WW, Jeekel J, van Geldorp HJ et al. Abdominal adhesions: intestinal obstruction, pain, and infertility. Surg Endosc. 2003;17:1017-1022.
Duron JJ. Postoperative intraperitoneal adhesion pathophysiology. Colorectal Dis. 2007;9(suppl 2):14-24.
Duron JJ, Silva NJ, du Montcel ST et al. Adhesive postoperative small bowel obstruction: incidence and risk factors of recurrence after surgical treatment: a multicenter prospective study. Ann Surg. 2006;244:750-757.
Miller G, Boman J, Shrier I, Gordon PH. Etiology of small bowel obstruction. Am J Surg. 2000;180(1):33-36.
Takeuchi K, Tsuzuki Y, Ando T et al. Clinical studies of strangulating small bowel obstruction. Am Surg. 2004;70:1:40-44.
Zerey M, Sechrist CW, Kercher KW, Sing RF, Matthews BD, Heniford BT. Laparoscopic management of adhesive small bowel obstruction. Am Surg. 2007;73(8):773-778.
Grinev M.V., Grinev K.M. Klinicheskie ekvivalenty patogeneticheski obuslovlennykh narushenii mikrotsirkulyatornogo rusla pri kriticheskikh sostoyaniyakh v neotlozhnoi khirurgii. Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya. 2009;8:4(32):35-40.
Savel'ev V.S., Lubyanskii V.G., Petukhov V.A. Dismetabolicheskie posledstviya sindroma kishechnoi nedostatochnosti v abdominal'noi khirurgii Annaly khirurgii. 2005;6:39-42.
Wiesner W, Khurana B, Ji H, Ros PR. CT of acute bowel ischemia. Radiology. 2003;226(3):635-650.
Zdzitovetskii D.E., Borisov R.N., Beloborodov A.A. i dr. Korrektsiya poliorgannoi nedostatochnosti pri rasprostranennom gnoinom peritonite s iskhodnymi tyazhelymi proyavleniyami sistemnogo vospaleniya. Materialy VII Vserossiiskoi konferentsii obshchikh khirurgov s mezhdunarodnym uchastiem sovmestno s Plenumom problemnykh komissii «Neotlozhnaya khirurgiya» i «Infektsiya v khirurgii» Mezhvedomstvennogo nauchnogo soveta po khirurgii RAMN i Minzdravsotsrazvitiya RF. Otv. red. Gostishchev V.K.; redkol.: Kubyshkin V.A. i dr. Krasnoyarsk: Verso; 2012.
Kosinets V.A. Kompleksnoe lechenie rasprostranennogo gnoinogo peritonita. Materialy VII Vserossiiskoi konferentsii obshchikh khirurgov s mezhdunarodnym uchastiem sovmestno s Plenumom problemnykh komissii «Neotlozhnaya khirurgiya» i «Infektsiya v khirurgii» Mezhvedomstvennogo nauchnogo soveta po khirurgii RAMN i Minzdravsotsrazvitiya RF. Otv. red. Gostishchev V.K.; redkol.: Kubyshkin V.A. i dr. Krasnoyarsk: Verso; 2012.
Duron JJ, Tezenas du Montcel S, Berger A et al. Prevalence and risk factors of mortality and morbidity after operation for adhesive postoperative small bowel obstruction. Am J Surg. 2008;195:726-734.
Ergul E, Korukluoglu B. Peritoneal adhesions: facing the enemy. Int J Surg. 2008;6:253-260.
Moran BJ. Adhesion-related small bowel obstruction. Colorectal Dis. 2007;9(suppl 2):39-44.
Mucha PJr. Small intestinal obstruction. Surg Clin North Am. 1987;67(3):597-620.
Selezneva M.G. Ostrye erozivnye gastropatii. 2010;72:5:57-60.
EAST Practice Parameter Workgroup for Management of Small Bowel Obstruction: Practice management guidelines for small bowel obstruction. Chicago (IL): Eastern Association for the Surgery of Trauma (EAST). 2007;42.
Voskanyan S. Profilaktika ostrykh erozii, yazv i ostrogo pankreatita posle obshirnykh vnutribryushnykh operatsii. Vrach. 2010;10:65-69.
Gostishchev V.K. Ostrye gastroduodenal'nye yazvennye krovotecheniya: ot strategicheskikh kontseptsii k lechebnoi taktike. Sechenovskii vestnik. 2010;1:29-35.
Evseev M.A. Klinicheskoe techenie, prognozirovanie i profilaktika ostrykh posleoperatsionnykh porazhenii gastroduodenal'noi zony u bol'nykh starshikh vozrastnykh grupp. Saratovskii nauchnyi meditsinskii zhurnal. 2011;7:4:953-957.
Van Goor H. Consequences and complications of peritoneal adhesions. Colorectal Dis. 2007;9(suppl 2):25-34.
Stupin V.A. Sovremennye podkhody k lecheniyu krovotechenii iz ostrykh yazv zheludka i dvenadtsatiperstnoi kishki. Khirurgiya. 2010;8:48-53.
Nikol'skii V.I., Sergatskii K.I. Etiologiya i patogenez ostrykh gastro-duodenal'nykh iz"yazvlenii, oslozhnennykh krovotecheniem. Vestnik khirurgicheskoi gastroenterologii. 2009;4:53-63.
Tvertieva L.F. Voprosy etiopatogeneza ostrykh iz"yazvlenii zheludka i dvenadtsatiperstnoi kishki pri neotlozhnykh sostoyaniyakh. Khirurgiya. 2008;3:74-76.
Alaev A.N. Arterial'noe krovosnabzhenie bryzheechnogo otdela tonkoi kishki cheloveka i pozvonochnykh zhivotnykh: Dis. ... d-ra med. nauk. Stalingrad. 1951.
Zapadnyuk I.P., Zapadnyuk V.I., Zakharnya E.A., Zapadnyuk B.V. Laboratornye zhivotnye. Razvedenie, soderzhanie, ispol'zovanie v eksperimente. Kiev: Vishcha shkola; 1983.

Close metadata