THE EFFECT OF ALLOPURINOL PRETREATMENT ON INTESTINAL HYPOPERFUSION ENCOUNTERED AFTER CORRECTION OF INTESTINAL VOLVULUS

After reversal of blood flow following a prolonged period of ischemia, blood flow returns for a few seconds and is reduced afterward. This i s called ''no-reflow phenomenon.'' Antioxidants such as allopurinol ha ve been shown to prevent the occurrence of this phenomenon in organs o ther than the intestine. An experimental study was conducted to invest igate the effect of allopurinol pretreatment on intestinal blood flow after correction of intestinal volvulus in rabbits. In group 1, baseli ne intestinal blood flow (IBF) was evaluated using radiolabeled red bl ood cells. In group 2, 720 degrees intestinal volvulus was created and IBF was evaluated 6 hours later. In group 3, intestinal volvulus was created and devolvulus was performed 6 hours later. Intraperitoneal is otonic saline was injected 60 minutes before correction of the volvulu s. IBF was evaluated after correction of the volvulus. Group 4 had the same procedures as group 3, but allopurinol (200 mg/kg) was injected in place of the isotonic saline. IBF stopped 6 hours after volvulus. C ompared with the baseline group, IBF was significantly lower in the gr oup with volvulus + devolvulus (P < .01). The IBF of the allopurinol-t reated group was significantly higher than that of the isotonic saline group (P < .01) and it did not differ significantly from that of the baseline group. Histopathological examination showed that intestinal v olvulus leads to histological injury. The histological injury was more pronounced in the devolvulus group and was less severe in the allopur inol group in comparison to the isotonic saline pretreatment group (P < .01). It is concluded that allopurinol pretreatment prevents the int estinal hypoperfusion (no-reflow phenomenon) and histological injury e ncountered after correction of intestinal volvulus of 6 hours' duratio n. Copyright (C) 1996 by W.B. Saunders Company