LOWER-LIMB ISCHEMIA-REPERFUSION INJURY ALTERS GASTROINTESTINAL STRUCTURE AND FUNCTION

Background It has been suggested that bowel permeability is altered fo llowing abdominal aortic aneurysm surgery. The effect of ischaemia-rep erfusion injury to the lower limb on the morphological structure, neut rophil infiltration and permeability of the bowel was investigated. Me thods Histological assessment of the bowel was undertaken in five grou ps of Wistar rats: control, 3 h of bilateral hind limb ischaemia and 3 h of bilateral hind limb ischaemia followed by 1, 2 or 3 h of reperfu sion. Using an everted gut sac model and C-14-labelled polyethylene gl ycol, the effect of ischaemia-reperfusion on small bowel permeability was studied. Results The small bowel showed a significant decrease in mucosal thickness, villus height and crypt depth in animals subjected to ischaemia followed by 2-hr reperfusion (mean(s.e.m.) 420(15), 217(9 ) and 163(6) mu m respectively) compared with controls (481(11), 245(6 ) and 195(6) mu m) (P<0.05). Neutrophil count within the lamina propri a was similar in the different groups. A significant increase in mean( s.e.m.) C-14-labelled polyethylene glycol translocation was detected i n animals subjected to ischaemia-reperfusion compared with controls (7 60(40) versus 560(27) c.p.m. per mi per h) (P<0.05). Conclusion These data suggest that reperfusion of acutely ischaemic extremities produce s structural and functional changes in the small intestine, although t hese changes are not associated with increased neutrophil infiltration within the bowel wall.