Morphometric Study of Hemomicrocirculatory Bloodstream of the Intestine in Acute Peritonitis
Despite the advances of modern surgery, peritonitis remains relevant general pathological problem. Syndrome of functional enteral insufficiency, developing in general peritonitis, is one of the leading causes of progressive microbial inflammation in the abdominal cavity and the clinical implementation of multiple organ dysfunction.
The aim of the study was morphometric research of hemomicrocirculatory disturbances in the wall of small and large intestine.
Material and Methods. An experimental study was conducted on mature white Wistar rats weighted 180–200 g. This rat strain is most often used to model the inflammatory processes. Inflammation model in this work was general aseptic peritonitis caused by injection of γ-carrageenan (Sigma, USA) 5 ml per 1 ml of isotonic solution. Animals in the experiment were divided into groups according to the temporal course of the pathological process: 1st group (6 rats) was the control (intact), 2nd (6 rats) after 12 hours after the onset of peritonitis, 3rd (6 rats) — after 24 hours, 4th (6 rats) after 48 hours, 5th group (6 rats) — after 72 hours from the onset of peritonitis.
To study the microcirculation of all rats were injected subcutaneously 1 ml of a 1% solution of trypan blue (my technique of E.U. Lipshitz) 40 minutes before organ retrieval.
Results and Discussion. The data of morphometric counting the number of vessels of various types per unit area, the diameter in the wall of the small and large intestines are presented.
In an early stage of peritonitis (12 hours from the start of the experiment) in the mucosa of the small intestine is unsharp venule dilatation.
In the submucosa and muscular layer morphometric data confirm the spasm of arterioles, reducing the capillary blood flow and the simultaneous persistent venule dilatation.
After 1 day from the beginning of the experiment (reactive stage of peritonitis) in intestinal mucosa average diameter venules, as in the previous period of the experiment, significantly increases and capillaries — on the contrary, decreases.
On the 2nd day of experimental peritonitis (toxic stage) in the mucosa of the small intestine occurs paralytic dilatation of the capillaries. The average diameter of venules was significantly more than in previous periods of the experiment.
On the 3rd day of experimental peritonitis (late stage) spasm of arterioles in the wall of the small and large intestine weakens. Paralytic dilation of the capillaries of the intestinal villi and crypts combined with the expansion of the venules, impaired blood rheology in the form of stasis, sludge syndrome, microtrombosis and permeability changes of the vascular walls.
Conclusions. 1. Based on this study, staging of clinical course of experimental peritonitis with characteristic for each stage hemomicrocirculatory changes was confirmed. 2. The most significant morphometric signs, reflecting the dynamics of hemomicrocirculatory violations in the intestine during general peritonitis, are the diameter of blood vessels and the number of vessels per unit area.
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