J.Jpn. Surg. Soc.. 60(4): 696-714, 1959

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THE EXPERIMENTAL STUDY ON THE INTESTINAL ADHESIONS

The author has investigated on mechanisms of the intestinal adhesions in 78 rabbits by histological and histochemical examinations. The lesions in various degrees are made aseptically by abrasion with gaus and by excision of the serosa and the muscular layers on the caecum of rabbits.
The results are as follows:
1. In 4 cases in which the normal serosa of the intestines are kept in contact together, there are no adhesions noticeable.
2. In 20 cases in which the serosa and subserosal tissue of one or both intestines in contact are removed, fibrinous adhesions take places but fibrous adhesions were not induced.
3. In 54 cases which shows defects in the serosa and the muscualr layers of the intestines, fibrinous adhesions at first and fibrous adhesions are later induced.
4. Fundamental forms of adhesions by means of histological examination: When the intestinal wall is injured, the lesion is covered with hemorrhage and fibrin-formation at first. Then proliferation of mesenchymal cells of the intestinal wall followes. As hemorrhage and cell infiltration in a great degree is induced in the cases that injuries are great, the neighbouring intestines are adhered together with formed fibrin, and then this fibrinous adhesion is dissolved to be removed with the proliferation of mesenchymal cells of the both intestines. When this mesenchymal proliferations of the both intestines are fused together, the primary fibrous adhesion is induced on the both intestines. This adhesion becomes m mbranous or takes a cord-like form and is torn a part after all.
5. As a result of a histochemical examination on fluctuation of acidmucopolysaccharide in amount which is considered to play an important role in formation of fibre in the ground substance on adhesion of the intestine, it is found that the fluctuation of this substance in amount it is parallel with that of the mesenchymal cells of the intestine.
6. It is pointed out that the above-mentioned process of healing is similar to that of healing of an inflammation in aseptically feeded animal.
7. It is experessed that from the results of this expriments the author likes to conclude that reperitonialisation is necessary rather for prevention of the intestine from its perforation and penetration, reinforcement of the intestinal wall and diminution of intra-peritoneal infection than for prevention of adhesion.
8. It is discussed that a classification by Dunphy and Udupa on the wound healing of the skin is compatible with the process of adhesion of the intestine in this experiment.
(author's abstract)

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