EFFECTS OF OCTREOTIDE AND A-TOCOPHEROL ON BACTERIAL TRANSLOCATION IN EXPERIMENTAL INTESTINAL-OBSTRUCTION - A MICROBIOLOGICAL, LIGHT AND ELECTRON-MICROSCOPIC STUDY

Background/Aims: Bacterial translocation induced by intestinal obstruc tion is suggested to be due to increased intestinal luminal volume, le ading to intestinal overgrowth with certain enteric microorganisms and intestinal mucosal damage. If this suggestion is true, maintenance of intestinal mucosal integrity by a cytoprotective agent, alpha-tocophe rol, and inhibition of gastrointestinal secretions by octreotide shoul d decrease the incidence of bacterial translocation and extent of muco sal injury due to intestinal obstruction. Methods: Complete intestinal obstruction was created in the distal ileum of male Wistar Albino rat s by a single 3-0 silk suture. The animals received subcutaneous injec tions of 1 ml of physiologic saline (group 1) (PS 24) and 1 ml of sali ne containing octreotide acetate (100 mu gr/kg) (group 2) (OC 24) at 0 , 12 and 24 hours of obstruction. In group 3 (PS 48) and group 4 (OC 4 8), the rats were treated with subcutaneous physiologic saline (1 ml) and octreotide acetate (100 mu g/kg), respectively, beginning at the t ime of obstruction and every 12 hours for 48 hours. The rats in group 5 (Toc 24), were pretreated with intramuscular alpha-tocopherol 500 mg /kg on, day 1 and 8, and underwent laparotomy on day 9. A third dose o f alpha-tocopherol was injected at the time of obstruction on day 9 an d no treatment was given thereafter. We tested the incidence of bacter ial translocation in systemic organs and circulation and evaluated the histopathological changes in all groups. Results: Treatment with octr eotide acetate was found to be ineffective in reducing the incidence o f translocation, with no histopathological improvement. Mucosal damage scores, on the other hand in the alpha-tocopherol group were statisti cally less than those in the octreotide and control groups (p < 0.05). Additionally, alpha-tocopherol treatment decreased the incidence of o rgan invasion with translocating bacteria, although this difference di d not reach statistical significance. Conclusion: Octreotide acetate t reatment in complete intestinal obstruction has no effect on the incid ence of bacterial translocation. alpha-Tocopherol, on, the other hand, has a cytoprotective effect on intestinal mucosa in intestinal obstru ction which, in turn, is thought to decrease bacterial translocation w hen used in physiological doses and prophylactically.