Distension enterogenesis: increasing the size and function of small intestine.
BACKGROUND
The purpose of this study is to evaluate the feasibility of using saline infusion to lengthen small bowel while preserving intestinal enzymatic function.


METHODS
Male Sprague-Dawley rats had a 3-cm jejunal segment taken out of continuity. A catheter was inserted in the proximal end, and the distal end was oversewn. Continuous infusion of saline into the isolated jejunal segment was started 2 weeks postoperatively. Segments were harvested 1 week later. Segment weights and lengths were measured preoperatively and at the time of harvest. Histology of harvested segments was performed. Alkaline phosphatase (ALP) and lactase assays were performed. Comparisons were made with normal jejunum from control animals.


RESULTS
A 32% increase in length was achieved with saline distension of small intestine. The segment weight to length ratio was significantly increased by saline distension; however, the total protein-to-weight ratio was unchanged. Specific activities of ALP and lactase were not affected by saline distension. Because of the increased length and weight of the distended jejunal segments, total segment activities for both enzymes were significantly increased.


CONCLUSIONS
Saline infusion appears to be a viable method for increasing small intestinal length without compromising enzymatic function. This phenomenon may provide a new method for the treatment of patients with short bowel syndrome in the future, and further study is warranted.
Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, USA.
Devin P
DP
Puapong
Benjamin M
BM
Wu
Mandy M
MM
Lam
James B
JB
Atkinson
James C Y
JC
Dunn
D000818:Animals; D007421:Intestine, Small / Q000254:growth & development* / Q000502:physiology*; D008297:Male; D009929:Organ Size; D051381:Rats; D017207:Rats, Sprague-Dawley; D015626:Tissue Expansion / Q000379:methods*