Morphological and Functional Changes in the Gut after Massive Small Bowel Resection and Colon Interposition in Rhesus Monkeys

Abstract

An experimental model of massive small bowel resection and colonic autograft in an antiperistaltic fashion in between the remnants of jejunum and ileum was developed in Rhesus monkeys. The gross morphological changes showed significant (p less than 0.001) lengthening and dilatation of the remnant jejunum, ileum and the colonic graft. Hypertrophy and hyperplasia of the mucosal and muscular layers of all the 3 segments was revealed by morphometric studies and the estimation of the nucleic acid content of the mucosa. All the 3 segments of the bowel showed a significant increase (p less than 0.001) in the uptake of D-glucose, L-alanine and L-phenylalanine when compared to the control animals. These changes were more pronounced in the animals kept for longer duration. Phlorizin was found to be inhibitory for the uptake of D-glucose in the grafted colon, suggesting the induction of an active nonelectrolyte transport process in the autografted colon. The present study suggests that the colonic loop adapts itself to the functions of the small bowel along with the compensatory adaptation of the remnant jejunum and the ileum for the loss of absorptive surface secondary to massive small bowel resection .