先天性腸狭窄閉鎖症の発生病理に関する実験的研究 : 家兎胎児手術による腸管(小腸大腸)血流遮断
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概要
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Pathogenesis of congenital intestinal stenosis and atresia was investgated by the experi-mental fetal surgery. The segments of small and large intestines of 123 fetuses in 72 pregnant rabbits were dcvascularized by the partial exteriorization method at various stages of gestation. 73 fetuses (59.4%) were born alive one to eight post-operative days. Devascularized small intestine was created in 45 fetuses in which 22 perforations, 13 stenosis, 5 atresias and 5 other lesions were presented. On the other hand, 5 perforations, 13 stenosis, 7 atresias and 3 other lesions were observed in 28 alive delivered fetuses with devascularized large bowel. Pathohistological findings such as hemorrhagic infarct, regeneration of the mucosal epi-thelium and replacement by the granulation tissue were considered as the process to develop stenosis and atresia in the devascularized small and large bowels. However, the more defi-nitive stenosis and atresia that seemed to be due to the mucosal changes which might have occured in the earlier period and the muscular or serosal changes in the later period were observed in the devascularized large bowels. Electron microscopical study of the involved lesion showed regeneration, absorption and division of the mitochondria in the mucosal epithelial cells near the infarct which showed metabolic activities within these cells. Furthermore, swelling of the Auerbach plexus with the large nucleus of the neuron and increase of the glia cells near the infarct seemed to be re-ferable to disturbance of peristalsis of the devascularized segment. In conclusion, accidental interruption of the blood flow to the intestinal segment in fetus may be the cause of congenital stenosis or atresia of the small and large bowels.
- 日本小児外科学会の論文
- 1983-12-20