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EXPERIMENTAL GASTROENTEROLOGY

    1. City clinical hospital № 30, 603157, Nizhny Novgorod, Russia
    2. FSBEI HE “Privolzhsky Research Medical University” MOH Russia, 603005, Nizhny Novgorod, Russia
    3. Institute of Applied Physics RAS, 603950, Nizhny Novgorod, Russia

    Keywords: Аcute mesenteric ischemia, intestinal infarction, mesenteric arterial occlusion, microcirculation, optical coherence tomography, optical coherence angiography, acute bowel ischemia, small bowel strangulation, ischemic necrosis, morphometry, hemorrhagic necrosis

    Abstract:The objective is to study the morphometric signs of small bowel ischemic damage basing on intravital optical coherence tomography data and further histological analysis Materials and methods. The study was carried out on male Wistar rats with the use of two models of acute intestinal ischemia: acute occlusive mesenteric ischemia by а. jejunales ligation (group “I”) and acute arteriovenous ischemia by a small bowel loop and frill strangulation together with а. et v. jejunales (group “II”). The state of intramural vessels in vivo was evaluated with the use of optical coherence angiography (OCA). After the macroscopic signs of non-viability appeared the bowel was resected and its stepwise histological analysis was carried out. Results. Ischemic damage development in group “I” was accompanied by decrease of bowel wall thickness by 34,8–42,4% (p=0,032) due to submucous layer destruction — based on histological analysis data and also by decrease of total length of functioning intramural vessels by 4,6% (p=0,004) — based on OCA data. According to the OCA data in group “II” the length of functioning vessels decreased by 89,6%in the strangulated bowel loop and by 6,1% in adducent and abducent sections (p=0,001). In the strangulated loop histological specimens sharply dilated thrombosed veins were seen in all layers of bowel wall, seromuscular layer oedema and diapedesis hemorrhages of mucous coat also took place as well as bowel wall thickening by 25,2% in comparison with the intact one. Conclusions. Сomplex analysis of in vivo optical coherence tomography results and further histological analysis of ischemic small bowel wall made it possible to determine the morphological manifestations which are specifi c for arterial and arteriovenous mesenteric blood fl ow disorder. In cases of mesenteric artery occlusion hypoperfusion and mucous coat ischemia are predominant among pathogenetic mechanisms of bowel wall alteration. In the strangulated bowel the main factor of destruction and necrosis is acute insuffi ciency of venous outfl ow.

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    Ryabkov M. G., Baleev M. S., Kiseleva E. B., Sirotkina M. A., Romanov I. N., Gelikonov G. V., Bederina E. L., Mironov А. А., Beschastnov V. V., Gladkova N. D. Bowel wall in cases of acute ischemia: intravital optical coherence tomography and histological analysis data. Experimental and Clinical Gastroenterology. 2019;162(2): 96–101. (In Russ.) DOI: 10.31146/1682-8658-ecg-162-2-96-101
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    1. Research Institute of Human Morphology, 117418, Moscow, Russia

    Keywords: colon, rat, newborn, prepubescent, enteric nervous system, enteroendocrine cells, serotonin, microfl ora

    Abstract:The aim was to characterize the structural and functional features of the nervous and endocrine systems and the microbiota composition of the colon in newborns and prepubescent Wistar rats. Materials and methods: The study was performed on 12 newborns and 13 prepubescent male Wistar rats. We used immunohistochemical methods to investigate the structure of the intermuscular nerve plexus and to detect endocrine cells in the colon. The concentration of serotonin in the colon wall and peripheral blood plasma was evaluated with high-performance liquid chromatography. The ratio of the main taxa of bacteria of the luminal microbiota was determined by real-time PCR. Results: We identifi ed that in the neonatal period the intermuscular nerve plexus was not completely formed, there were few glial cells in the ganglia. The relative number of enteroendocrine cells and the serotonin content in the intestinal wall and in blood at this age period was minimal. The composition of the luminal microbiota in newborn rats was characterized by the predominance of taxons Firmicutes, Enterobacteria. In comparison with the newborns the intermuscular nerve plexus in the prepubescent rats was mature: the neural network formed large mesh, while the number of glial cells in the ganglia increased 3–4 times. The number of enteroendocrine cells increased 2.5 times, the content of serotonin in the colon wall and peripheral blood increased almost 80 and 6000 times, respectively. Firmicutes predominated in the luminal microfl ora, the number of Bifi dobacteria, Enterobacteria decreased.

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    Tikhonov E. A., Zolotova N. A., Khochansky D. N., Makarova O. V. Structural and functional characteristic of the nervous and endocrine systems and the microbiota composition in the colon of the newborn and prepubescent wistar rats. Experimental and Clinical Gastroenterology. 2019;162(2): 102–106. (In Russ.) DOI: 10.31146/1682-8658-ecg-162-2-102-106
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    1. Central State Medical Academy of Department of Presidential Aff airs, Moscow, Russia
    2. City Clinical Hospital № 1. named N. I. Pirogov, Moscow, Russia
    3. Polyclinic № 2, Moscow, Russia
    4. MEDSI, Moscow, Russia

    Keywords: abdominal MDCT, CT diagnosis of pathology of the colon wall, CT diagnosis of Crohn’s disease. CT diagnosis of lymphoma of the colon

    Abstract:Thickening of the wall of the colon (TC) is one of the easily detectable and common symptoms of TC diseases detected by computed tomography (CT). The aim of the study was to reveal the possibilities of standard abdominal CT in the diagnosis of TC disease. To achieve this goal, 359 CT of the abdominal cavity performed according to the standard Protocol were analyzed. The average age of patients was 64.1+15.8 years. Gender ratio: prevalence of male patients 1,3:1,0. The normal thickness of the wall of the colon depends on the degree of expansion of the lumen or stretching and in most cases is changeable. The thickening of the TC wall was considered to be a persistent mismatch of its thickness to the inner lumen or outer diameter, taking into account the extreme values of the norms according to the literature data from 2 to 10 mm. The Analyzed cases of thickening of the TC wall were divided into 3 groups: focal (53%), segmental (30%) or diff use thickening (17%). Wall thickening defi ned in nonspecifi c infl ammatory diseases (Crohn’s disease, ulcerative colitis, undiff erentiated, pseudomebranous and ischemic colitis) often had segmental (12%) or diff use (16%) length, with a minimum in the group of focal thickening — 1% in Crohn’s disease. The authors determined a signifi cant diff erence in the length of TC wall thickening in benign and malignant processes (p<0.05). The probability of diagnosis of TC cancer signifi cantly increases with a decrease in the length of the determined thickening of the TC wall to the focal, with an inverse relationship with an increase and a high probability of infl ammatory disease (p<0.01). Thus, the symptom of thickening of the wall of the TC is a marker symptom of diseases of the TC. In our study, the thickening of the TC wall was found in both malignant and benign diseases, with the prevalence of the latter, and a large proportion of infl ammatory diseases in them (p<0.05). In the group of focal thickenings, the leader, not taking into account diverticulitis due to easily recognizable signs of this disease, was TC cancer, which indicates in favor of the high specifi city of the sign (p<0.01). However, the analysis of additional features was crucial in the diff erential diagnosis of TC pathology: the type and nature of contrast enhancement, changes in mesentery, fi ber and adjacent vessels.

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    Koshelev E. G., Kitayev S. V., Belyaev G. Yu., Egorov A. A. CT diagnosis of diseases manifested by thickening of the colon wall. Experimental and Clinical Gastroenterology. 2019;162(2): 107–119. (In Russ.) DOI: 10.31146/1682-8658-ecg-162-2-107-119
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