title: Crohn's disease and anastomotic recurrence: microvascular ischaemia and anastomotic healing in an animal model.
abstract: Microvascular injury and ischaemia may be factors in anastomotic recurrence after resection for Crohn's disease. This hypothesis was explored in a ferret model of multifocal intestinal infarction. At laparotomy, isolated loops of small intestine were injected intraarterially with styrene microspheres (test loop) or saline (control). At a second laparotomy 72 h later, test and control loops were divided and an end-to-end anastomosis performed between test loops (n = 2), test and control loops (n = 9) or control loops (n = 2). Abnormalities including chronic transmural inflammation, ulceration and granuloma formation were identified 2 weeks after the second operation in ten of the 11 surviving animals; changes were confined to the test loops and were more prominent adjacent to the anastomosis. No abnormalities were seen in control loops. The combination of two self-limiting ischaemic insults can produce a pattern of intestinal inflammation similar to that seen in anastomotic recurrence in Crohn's disease.
authors.affiliation: University Department of Surgery, Royal Free Hospital and School of Medicine, London, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Osborne
authors.forename: M
authors.initials: M
authors.lastname: Hudson
authors.forename: C
authors.initials: C
authors.lastname: Piasecki
authors.forename: A P
authors.initials: AP
authors.lastname: Dhillon
authors.forename: A A
authors.initials: AA
authors.lastname: Lewis
authors.forename: R E
authors.initials: RE
authors.lastname: Pounder
authors.forename: A J
authors.initials: AJ
authors.lastname: Wakefield
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D003424:Crohn Disease / Q000503:physiopathology / Q000601:surgery*; D004195:Disease Models, Animal; D005289:Ferrets; D007421:Intestine, Small / Q000098:blood supply / Q000601:surgery*; D007511:Ischemia / Q000209:etiology; D012008:Recurrence; D014945:Wound Healing