Abdominal insufflation-deflation injury in small intestine in rabbits.
OBJECTIVE
To investigate the effect of increased intra-abdominal pressure followed by abdominal deflation on small intestine with or without previous intestinal ischaemia.


METHODS
Randomised experimental study.


METHODS
University hospital, Turkey.


METHODS
78 male New Zealand white rabbits.


METHODS
Experiment 1: 30 rabbits (10 in each group) were subjected to intra-abdominal pressure of 0 mmHg (controls), 15 mmHg or 25 mmHg for 60 minutes. Experiment 2: 48 rabbits were divided into four groups (n = 12 in each). The first comprised sham-operated controls. In the other 3, the superior mesenteric artery was occluded for 60 minutes. Reperfusion was started and maintained under intra-abdominal pressure of 0 mmHg, 15 mmHg, or 25 mmHg for one hour. Intestinal specimens were obtained five and 60 minutes after abdominal deflation in the pressure groups and at identical times in the other groups in both experiments.


METHODS
Intestinal malondialdehyde concentration, wet:dry intestinal weight ratio, and mucosal injury score under light microscopy.


RESULTS
In experiment I the malondialdehyde concentration, wet:dry weight ratio, and mucosal injury scores were higher in the 25 mmHg group than in the other groups in both specimens. There was a significant increase in malondialdehyde concentration in the 15 mmHg group in only the 5-minute specimen. In experiment 2, except for the wet:dry weight ratio in the 5-minute specimen in the 15 mmHg group, there were significant increases in malondialdehyde concentration, wet:dry weight ratio, and mucosal injury score in all groups except controls in both specimens. Malondialdehyde concentration and wet:dry weight ratio were higher in the 25 mmHg group than in the 0 mmHg group in the 60-minute specimen, and higher than the 15 mmHg group in both specimens. Wet:dry weight ratio was less in the 15 mmHg group than the 0 mmHg group in both specimens. Mucosal injury score was higher in the 25 mmHg group than the other groups in both specimens.


CONCLUSIONS
Increased intra-abdominal pressure for 60 minutes followed by abdominal deflation led to an ischaemia-reperfusion-like injury in normal small intestine in rabbits, and added to reperfusion injury in the ischaemic small intestine at an intra-abdominal pressure of 25 mmHg.
Kaya
Yavuz
Y
Departments of Surgery, Celal Bayar University Medical Faculty, Manisa, Turkey. ydakaya@hotmail.com
Coskun
Teoman
T
Demir
Mehmet A
MA
Var
Ahmet
A
Ozsoy
Yucel
Y
Aydemir
Ece O
EO
D000007:Abdominal Injuries / Q000503:physiopathology*; D000704:Analysis of Variance; D000818:Animals; D004195:Disease Models, Animal; D007421:Intestine, Small / Q000098:blood supply*; D007511:Ischemia / Q000209:etiology* / Q000503:physiopathology; D019194:Ischemic Preconditioning; D008297:Male; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects* / Q000379:methods; D011312:Pressure; D011336:Probability; D011817:Rabbits; D011897:Random Allocation; D012016:Reference Values; D015427:Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric