ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Intestinal Ischemia And Bacterial Translocationin The Abdominal Compartment Syndrome
Yusuf YAĞMUR*, Mustafa ALDEMİR**, Hayrettin ÖZTÜRK***, Cahfer Güloğlu****,
M.Faruk GEYİK*****, Mehmet ORUCU******
* Doç.Dr., Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi AD,
** Uz.Dr., Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi AD,
*** Uz.Dr., Dicle Üniversitesi Tıp Fakültesi Çocuk Cerrahi AD,
**** Uz.Dr., Dicle Üniversitesi Tıp Fakültesi İlk ve Acil Yardım AD,
***** Yrd.Doç.Dr., Dicle Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji AD/
****** Uz.Dr., Dicle Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon AD, DİYARBAKIR
The abdominal compartment syndrome-massive abdominal distention, increased central venous pressure, decreased urinary output, and the need for increased ventilatory pressure-has been observed in a variety of situations, including postoperative intra-abdominal hemorrhage, complicated severe abdominal trauma and peritonitis accompanied by visceral swelling, and peritoneal insufflation during laparoscopic procedures. Although the effects of raised intraabdominal pressure on systemic and splanchnic hemodynamics have been described, the consequences of the resultant gut hypoperfusion in this setting are not well known. Bacterial translocation occurs after a period of splanchnic ischemia and may contribute to later organ failure. In this study, 20 wistar-albina rats (235+-20 gram) were used. In group 1 (n= 10 control) a midline laparotomy was done and intraabdominal pressure was not increased. In group 2 (n=10), after midline incision, intraabdominal pressure was increased to 20 mmHg for 60 minutes for examining the effect of raised intraabdominal pressure on bacterial translocation. In all rats, mean arterial blood pressure was maintained with fluid. 24 hours later, a portion of mesenteric lymph node, liver and spleen were obtained for culture for assessing bacterial translocation. A portion of liver and small bowel were obtained for measuring malondialdehyde level. Finally, a portion of small bowel was obtained for histopathologic changes and evaluated with scoring system. Bacterial translocation occurred to the mesenteric lymph nodes after 60 minutes of increased intraabdominal pressure at 20 mmHg (p<0.05). Malondialdehyde increased in the liver and small bowel (p<0.05 for both). Histological analysis showed normal intestinal tissue among the biopsy specimen from group 1 and desquamation or necrosis of the upper third of the villi in group 2. Increased intraabdominal pressure leads to decreased intessmall bowel, and to bacterial translocation, which may contribute to later septic complications and organ failure.Keywords: Abdominal compartment syndrome,
Intestinal ischemia,
Bacterial translocationTurkiye Klinikleri J Med Sci 2000, 20:197-202
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