原创力文档real-time in vivo imaging of early mucosal changes during ischemia-reperfusion in human jejunum实时在体成像的早期人类空肠粘膜缺血再灌注期间的变化.pdfVIP
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real-time in vivo imaging of early mucosal changes during ischemia-reperfusion in human jejunum实时在体成像的早期人类空肠粘膜缺血再灌注期间的变化
Real-Time In Vivo Imaging of Early Mucosal Changes
during Ischemia-Reperfusion in Human Jejunum
1 2 2 1 1
Joep Grootjans , Wim Hameeteman , Ad A. Masclee , Ronald M. van Dam , Wim A. Buurman ,
Cornelis H. C. Dejong1*
1 Department of Surgery, NUTRIM School for Nutrition, Toxicology Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands, 2 Department of
Gastroenterology, NUTRIM School for Nutrition, Toxicology Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
Abstract
Background and study aims: Small intestinal ischemia-reperfusion (IR) is a frequent, potentially life threatening
phenomenon. There is a lack of non-invasive diagnostic modalities. For many intestinal diseases, visualizing the intestinal
mucosa using endoscopy is gold standard. However, limited knowledge exists on small intestinal IR-induced, early mucosal
changes. The aims of this study were to investigate endoscopic changes in human jejunum exposed to IR, and to study
concordance between endoscopic appearance and histology.
Patients and methods: In 23 patients a part of jejunum, to be removed for surgical reasons, was isolated and selectively
exposed to ischemia with 0, 30 or 120 minutes of reperfusion. In 3 patients, a videocapsule was inserted in the isolated
segment before exposure to IR, to visualize the mucosa. Endoscopic view at several time points was related to histology
(Heamatoxylin Eosin) obtained from 20 patients.
Results: Ischemia was characterized by loss of villous structure, mucosal whitening and appearance of punctate lesions. This
was related to appearance of subepithelial spaces and breaches in the epithelial lining in the histological view. Early during
reperfusion, th
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