Microangiographic studies of intestinal vasoarchitecture with special reference to ulcerogenesis in Crohn's disease.

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As reported previously, histometrical studies of the arterial media demonstrated increasd vascular resistance in the vasa recti of the intestine in Crohn's disease. Such vascular response may result in different types of ulceration in accordance with variations in the vascular architecture of the intestine. In the present study, we investigated the microangiographic appearane of the small and large intestine in cadaver specimens.<BR>In the antimesenteric side of the small intestine, anastomotic vessels between the submucosal arteries were large in diameter and relativety abundant in comparison with those in the mesenteric side. In the large intestine, the mesenterium was widely attached to the colonic wall between three tenias, where the vasa recti pierce the muscular wall randomly. Also the distribution of the Subminal arteries was not as regular as that seen in the small intestine.<BR>These results indicated that ischemia, dependent not only on specific vascular response but also vascular architecture, may play an important role in ulceration in Crohn's disease. Especially, asynchronous vasoconstriction of the vasa recti might cause a longitudinal ischemic area on the mesenteric side as an underlying lesion of the longitudinal ulcer of the small intestine in Crohn's disease.
日本大腸肛門病学会の論文