The Experimental Study on the Intraperitoneal Adhesions:—Scanning and Transmission Electron Microscopic Observation on the Reactions of Peritoneal Mesothelial Cells against Foreign Bodies—
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概要
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The postoperative adhesions of the bowel are one of the troublesome complications, occasionally to be a major cause of intestinal obstructions. However, the pathogenesis of peritoneal adhesions is still not clearly understood.This study has been performed to elucidate ultrastructurally the process of intestinal adhesions caused by intraperitoneal injection of foreign bodies.The physiological saline solution, diluted hen's bile and 0.2% and 2% colloidal silica were injected into the peritoneal cavity of mice. Then, the surface of the small intestine was observed with a transmission and a scanning electron microscope.The surface of the small intestine is covered with the serosa, one layer of the mesothelial cells. The surface of the cells was slightly bulged like a dome and covered with a lot of the long and thin microvilli. The cytoplasm had a large nucleus and many organelles, especially numerous pinocytotic vesicles.The intraperitoneal injection of the physiological saline solution showed no macroscopic and ultrastructural change on the mesothelial cells.The injection of the hen's bile and colloidal silica showed remarkable change on the mesothelial cells. The surface of the cells was swollen and microvilli were irregularly distributed, transformed and shortened to be like a club. These changes increased gradually, and fibrin-like deposits were observed on some cells, loosing microvilli, 12 hours after injection. The intercellular space was expanded and numerous small vesicles in the cytoplasm were observed 3 days after injection. Some macrophage-and fibroblast-like cells, surrounding damaged cells, were observed. They might be to become new mesothelial cells.On the other hand, the regeneration and repair of the mesothelial cells, e.g. increase in number and length of microvilli, etc., were already seen one or two days after the injection and almost all of the cells seemed to be ultrastructurally normal about on the 21 th day after injection.No macroscopic adhesions among bowels were seen in this experiments. Therefore, not only the damages of the mesothelial cells but also injuries to the muscular layer, condition of the peristalsis and local circulation of the bowel, injection, etc., were presumably concerned with the establishment of the intraperitoneal adhesions.
- 近畿産科婦人科学会の論文
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