Phasic study of intestinal homeostasis disruption in experimental intestinal obstruction

Role of Multi-Detector Computed Tomography in the Diagnosis of Intestinal Obstruction

INTRODUCTION

There is a need to identify patients whose small bowel obstruction (SBO) can resolve spontaneously so that unnecessary surgical interventions are avoided. This study aimed to evaluate the diagnostic accuracy of multi-detector computed tomography (MDCT) in intestinal obstruction and find out the presence, level, causes, and degree of intestinal obstruction taking intraoperative findings as gold standard.

METHODOLOGY

This cross-sectional study was conducted analyzing 147 patients that were referred from emergency with abdominal pain, abdominal distension, inability to pass flatus, and aged 18-70 years from both genders. Computed tomography (CT) examinations were done and findings like intestinal dilatation, evidence of mesenteric fat stranding, and area of transition between the dilated and collapsed loops were noted. The final report was made by the radiologist while the operative findings were reviewed from the operative notes written by operative surgeons of the same patient.

RESULTS

In a total of 147 patients, mean age was 52.38±16.01 years. There were 76 (51.70%) males and 71 (48.30%) females. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of multi-detector computed tomography scan in diagnosing intestinal obstruction, taking operative findings as gold standard, were 98.39%, 65.22%, 93.85%, 88.24%, and 93.20%, respectively.

CONCLUSION

The multi-detector CT can be used routinely as a prime modality for detecting intestinal obstruction which will result in proper and timely management for reducing the morbidity and mortality of these particular patients.

Structural and quantitative alterations of gut microbiota in experimental small bowel obstruction

OBJECTIVE

To investigate structural and quantitative alterations of gut microbiota in an experimental model of small bowel obstruction.

METHOD

A rat model of small bowel obstruction was established by using a polyvinyl chloride ring surgically placed surrounding the terminal ileum. The alterations of gut microbiota were studied after intestinal obstruction. Intraluminal fecal samples proximal to the obstruction were collected at different time points (24, 48 and 72 hours after obstruction) and analyzed by 16s rDNA high-throughput sequencing technology and quantitative PCR (qPCR) for target bacterial groups. Furthermore, intestinal claudin-1 mRNA expression was examined by real-time polymerase chain reaction analysis, and serum sIgA, IFABP and TFF3 levels were determined by enzyme-linked immunosorbent assay.

RESULTS

Small bowel obstruction led to significant bacterial overgrowth and profound alterations in gut microbiota composition and diversity. At the phylum level, the 16S rDNA sequences showed a marked decrease in the relative abundance of Firmicutes and increased abundance of Proteobacteria, Verrucomicrobia and Bacteroidetes. The qPCR analysis showed the absolute quantity of total bacteria increased significantly within 24 hours but did not change distinctly from 24 to 72 hours. Further indicators of intestinal mucosa damage and were observed as claudin-1 gene expression, sIgA and TFF3 levels decreased and IFABP level increased with prolonged obstruction.

CONCLUSION

Small bowel obstruction can cause significant structural and quantitative alterations of gut microbiota and induce disruption of gut mucosa barrier.

Gastrointestinal Diseases of Rabbits

Gastrointestinal stasis syndrome is a very common presentation of an ill rabbit to the veterinarian. The causes involved in this syndrome are often multifactorial, and an inappropriate diet puts the rabbit at a greater risk of developing this syndrome. Complications of this disorder can lead to gastrointestinal obstruction, a life-threatening condition that necessitates aggressive medical and in some case surgical therapy. Rabbits may also be presented with signs of diarrhea. However, abnormal cecotrophs must be differentiated from true intestinal diarrhea. The common causes, diagnosis and management of diarrhea including dysbiosis and enteritis are discussed. Other important causes of gastrointestinal disease are infectious disease and liver lobe torsion. Rabbit hemorrhagic disease virus has a new variant that has been identified in mainland Europe, the United Kingdom, and Australia. Subclinical infection of intestinal coccidiosis is a common cause of weight loss in adult rabbits. Liver lobe torsion is a challenging condition to diagnose in rabbits; this chapter discusses the presenting signs, diagnostic techniques, and therapeutic options.