Bacterial translocation in obstructive jaundice in rats: role of mucosal lacteals.
OBJECTIVE
To study the ultrastructure of the ileal wall in rats with obstructive jaundice alone and after passive external biliary drainage to see if we could discover the reason for the increased risk of infective complications and multisystem failure in the presence of obstructive jaundice and after external biliary drainage.


METHODS
Histological examination of the wall of the terminal ileum using light microscopy, as well as scanning and transmission electron microscopy (EM).


METHODS
Experimental laboratory, Republic of Georgia.


METHODS
56 adult male Wistar rats.


METHODS
Rats were divided into 7 groups: controls (not operated on, n = 6); sham-operated and studied after 6 and 12 days (n = 6 in each); bile duct ligation alone studied after 6 and 12 days (n = 10 in each); and bile duct ligation followed 6 and 12 days later by one-day of external biliary drainage (n = 9 in each).


METHODS
Percentage of destroyed villi.


RESULTS
The extent of oedema of villi, necrosis of neurons, and disturbances in the secretory capacity of enterocytes correlated well with the duration of cholestasis. After 6 and 12 days ligation alone 7.2% and 17.3%, respectively, of villi were found to be destroyed; their connective tissue framework including lymphatics was in direct contact with the intestinal contents. The changes were not reversed by one day of external biliary drainage.


CONCLUSIONS
The gaps in the ileal mucosa caused by obstructive jaundice (and not relieved by one day of external biliary drainage) may enable gut bacteria and their endotoxin to reach the systemic circulation through the lymphatic-system. This could increase the risk of infective complications.
Kordzaya
D J
DJ
First Department of Surgery, Institute of Surgery, Tbilisi, Georgia.
Goderdzishvili
V T
VT
D000818:Animals; D018988:Bacterial Translocation / Q000502:physiology*; D002779:Cholestasis / Q000473:pathology / Q000503:physiopathology*; D007082:Ileum / Q000473:pathology / Q000648:ultrastructure*; D007413:Intestinal Mucosa / Q000473:pathology / Q000503:physiopathology / Q000648:ultrastructure*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D017348:Microscopy, Electron, Scanning Transmission; D051381:Rats; D017208:Rats, Wistar