Adverse effects of increased intra-abdominal pressure on small bowel structure and bacterial translocation in the rat.
BACKGROUND
The purpose of this study was to evaluate the effects of elevated intra-abdominal pressure (IAP) on intestinal structures and bacterial translocation in the rat.


METHODS
Forty-two male Sprague-Dawley rats were randomly divided into three experimental groups of 14 rats each: the sham group underwent insertion of a balloon-tipped catheter; the IAP-15 group was subjected to a 15 mm Hg pneumoperitoneum for 60 minutes; and the IAP-25 group was subjected to a 25 mm Hg pneumoperitoneum for 60 minutes. Intestinal structural changes (bowel circumference, overall bowel and mucosal weight, mucosal DNA and protein, villus height, and crypt depth) and bacterial translocation to mesenteric lymph nodes, liver, spleen, portal blood, and peripheral blood were determined 24 hours following pneumoperitoneum.


RESULTS
IAP-15 and IAP-25 rats demonstrated a significant decrease in: bowel and mucosal weight in the duodenum, jejunum, and ileum; mucosal DNA and protein in the jejunum and ileum; villus height in the jejunum: and crypt depth in the jejunum and ileum compared to the sham rats. Bacterial translocation was demonstrated in 60% of IAP-15 rats and in 80% of IAP-25 rats.


CONCLUSIONS
Elevated IAP results in mucosal injury of the gut, causing mucosal hypoplasia, and increases bacterial translocation.
Sukhotnik
Igor
I
Department of Pediatric Surgery B, Bnai Zion Medical Center, Haifa, Israel. igor-dr@internet-zahav.net
Bejar
Jacob
J
Srugo
Isaac
I
Krausz
Michael M
MM
Bernshteyn
Aleksander
A
Hirsh
Mark
M
Mogilner
Jorge G
JG
D015998:Abbreviated Injury Scale; D000399:Air Pressure; D000818:Animals; D018988:Bacterial Translocation; D004247:DNA / Q000378:metabolism; D004386:Duodenum / Q000473:pathology; D013293:Enterococcus faecalis / Q000502:physiology; D004926:Escherichia coli / Q000502:physiology; D007082:Ileum / Q000473:pathology; D007413:Intestinal Mucosa / Q000382:microbiology / Q000473:pathology*; D007421:Intestine, Small / Q000382:microbiology / Q000473:pathology*; D007583:Jejunum / Q000473:pathology; D007709:Klebsiella / Q000502:physiology; D008297:Male; D023421:Models, Animal; D020613:Morganella morganii / Q000502:physiology; D009929:Organ Size; D010919:Placebos; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011506:Proteins / Q000378:metabolism; D011549:Pseudomonas / Q000502:physiology; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D013211:Staphylococcus aureus / Q000502:physiology
D010919:Placebos; D011506:Proteins; D004247:DNA