1991 Fiscal Year Final Research Report Summary

Effects of Intraluminal Pressure and Decompression on Intestinal Obstruction

Research Project

Project/Area Number	02670589
Research Category	Grant-in-Aid for General Scientific Research (C)
Allocation Type	Single-year Grants
Research Field	Digestive surgery
Research Institution	Teikyo University School of Medicine
Principal Investigator	SHIKATA Jun-ichi First Department of Surgery, Teikyo University School of Medicine, 医学部・第一外科教室, 教授 (10082083)
Co-Investigator(Kenkyū-buntansha)	MIYAJI Suguru First Department of Surgery, Teikyo University School of Medicine, 医学部・第一外科学教室, 助手 (30200174) AMINO Kenjiro First Department of Surgery, Teikyo University School of Medicine, 医学部・第一外科学教室, 助手 (10129968) MIURA Seiji First Department of Surgery, Teikyo University School of Medicine, 医学部・第一外科学教室, 助教授 (00165961)
Project Period (FY)	1990 – 1991
Keywords	Intestinal obstruction / Intraluminal pressure / Endotoxin / Intestinal blood flow / Hemodynamics
Research Abstract	In small bowel obstruction, intraluminal pressure in the distended bowel is one of the most important and basic factors in its pathophysiology. To elucidate a part of the pathophysiology of the bowel obstruction, intraluminal pressure, regional blood flow, and serum endotoxin in small bowel obstruction were investigated. Hemodynamics of hepatic blood flow in endotoxin shock was also studied. Nonstrangulative obstruction was induced experimentally in the canine small intestine of dogs. The intraluminal pressure of the distended intestine was measured every 24 hours for three days, while the dogs were kept in a prone position without being anesthetized. In the measurement of the intraluminal pressure, the hydraulic capillary infusion system (Arndorfer : AMS-600) connected with personal computer was used. It is considered that the intraluminal pressure values of the intestine, as measured by this system, are more physiologic. The significant elevation of the intraluminal pressure was showed on 2 days after simple bowel obstruction. The mean intraluminal pressure on 3 days after. obstruction was 17.9 mmhg in jejunum, and 20.2 mmhg in ileum. The intraluminal pressure values in our experiments are higher than those reported in the past. In motility responses elicited by prostaglandin, the mean pressure amounting 30 mmHg were recorded. Some alterations in regional blood flow and elevation of serum endotoxin levels were also showed in the experimental simple small bowel obstruction. The simple concept of increasing intraluminal pressure provoking directly vascular stasis, edema, and eventually, ischemic damage was abandoned by our studies. It, is suggested that many factors such as elevation of intraluminal pressure, secretory activity of intestine, absorptional disorder of intestine, a tremendous broliferation of the bacterial flora, and chemical mediator sustances are related to the pathophysiology of the intestinal obstruction.