J.Jpn. Surg. Soc.. 91(9): 1466-1469, 1990

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Report on the annual meeting

PREDICTIVE ESTIMATION OF INTESTINAL RECOVERY FROM ACUTE ISCHEMIC INJURY

Methods for the predictive estiamtion of intestinal recovery from ischemic injury were evaluated in highly reproducible model of segmental intestinal ischemia in rats. Systemic variables were minimized and survival was maximized by parenteral administration of antibiotics and nutrient solution, so that necrosis or recovery of the segment itself, not the rat, could be used as the end point of experiments. Intestinal viability was assessed by following methods. ①Standard clinical observation (color, peristalsis, pulsation). ②Fluorescence pattern after intravenous fluorescein injuection. ③Tissue blood flow measured by Laser doppler flowmeter. Findings were compared with ultimate viability assayed by histologic examination of each segment removed 48 hours after release of strangulation.
Five distinctive patterns of fluorescence were identified, two of which (normal and fine granular) reliably predicted survival, and other three (no fluorescence, perivascular, coarse granular) almost predicted subsequent necrosis.
Laser doppler flow above 3.5mV usually predicted recovery, and the flow below 3.5mV almost predicted necrosis. Standard clinical observations were relatively insensitive to detect viable segment comparing with the fluorescein method and Laser doppler method. This study suggests that the fluorescein and Laser doppler methods might reduce the false positive diagnosis of non viable even in human cases.

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