CONDITION OF THE SMALL INTESTINE IN THE ACUTE PERIOD OF BAROTRAUM

Abstract

Despite the fact that the explosion-induced trauma of the abdominal cavity among all acute surgical pathology is estimated at various sources from 1-3% to 33%, mortality from undiagnosed injuries remains high. According to clinical observations of explosion-induced trauma to the abdominal organs, the most vulnerable are the hollow organs, in particular the intestine, and parenchymal organs, namely the liver and spleen. The aim of the study was to study the effects of the acute period of barotrauma on the histomorphometric parameters of the intestine of white rats. Analysis of histological signs of the intestinal wall of experimental animals in the first hour after exposure to the shock wave showed that at the tops of the villi there was intense desquamation of enterocytes into the intestinal lumen, stroma villi swollen, in the submucosal and adventitial layers there are hollow cavities and cavities. Analysis of intestinal morphometric parameters showed that in the simulation of barotrauma (experimental group) the length of the villi was 304.53 μm (an increase of 10.5% compared with the control group), the width of the villi – 82.62 μm (an increase of 9.2% in compared with the control group), the length of the crypt – 298.14 μm (an increase of 15.5% compared to the control), the width of the crypt – 42.32 μm (an increase of 13.5% compared to the control). Analysis of the thickness of the intestinal wall as a whole and separately, in layers, showed that the thickness of the intestinal wall in rats after barotrauma was 705.46 μm (increase of almost 4%), the thickness of the mucous membrane – 542.14 μm (increase by 0.7%), the thickness of the muscular membrane – 151.32 μm (an increase of 2.7%). The serous membrane thickened the most and its thickness was 8.03 μm (60% increase). We associated all these changes with the acute phase, namely the edema caused by barotrauma. Thus, the impact of the shock wave on the anterior abdominal wall leads to diffuse trauma to the wall of the small intestine, which is accompanied by edema and dilation of the interstitial spaces, stratification of mucous, submucosal and serous membranes in the acute period of injury

Keywords

• barotrauma
• explosive injury
• intestinal wall.