RESUMEN
PURPOSE: The objective of the present study was to investigate the effect of segmental reversal of the distal 20 cm of the small intestine in piglets with induced SBS compared to controls with SBS alone. Primary endpoint was postoperative weight change over a period of 1 month. Secondary endpoints were the influence on cell proliferation and mucosal architecture shown by histological analysis. METHODS: Sixteen piglets underwent a 60% resection of the distal small intestine and were randomized into two groups. Group 1 short bowel syndrome alone (SBS) (n = 8) and group 2 with reversal of a distal small intestinal segment (SBS-RS) (n = 8). Body weight was measured daily and the pigs were euthanized after 1 month. Crypt depths, villus heights and muscle layers thicknesses were measured. For the evaluation of microvilli of the brush border of the epithelium and cell proliferation, immunohistochemical staining with Villin and Ki-67 was performed. RESULTS: No statistically significant differences were observed concerning weight gain. Mean ± SD weight gain was 2.31 ± 2.85 kg for SBS-RS and 2.03 ± 1.27 kg for SBS (p = 0.8). In the proximal jejunal segment a significant increase in villus heights was found in the SBS group and increase in the thickness of the circular and longitudinal muscle layers in the SBS-RS group. In the distal ileal segment the longitudinal muscle layer thicknesses were increased in the SBS group. Otherwise, no significant changes were found. CONCLUSION: Reversal of a 20-cm distal segment showed no effect on weight gain, but there were some significant histological changes of unknown clinical significance.
Asunto(s)
Peso Corporal , Intestino Delgado/patología , Síndrome del Intestino Corto/cirugía , Animales , Modelos Animales de Enfermedad , Intestino Delgado/cirugía , Microvellosidades/patología , Músculo Liso/patología , Distribución Aleatoria , PorcinosRESUMEN
Whipple's disease (WD) is a rare, chronic, systemic infection caused by the bacterium Tropheryma whipplei. New molecular techniques and epidemiological data over the latest decade have contributed to better understanding of this infection. The classical form of WD is characterized by arthritis followed years after by diarrhoea, weight loss and malabsorption but other clinical forms without intestinal involvement have been described. Prompt recognition and treatment of the infection is important, as the disease can be fatal if untreated. New studies are required to establish the optimal therapy regimen.