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A study on ischemic lesion of the large intestine from the morphological viewpoint of the experimental ischemic colitis

A study on ischemic lesion of the large intestine from the morphological viewpoint of the experimental ischemic colitis

Stomach & Intestine 28(9): 943-958

Ischemic lesion of the large intestine is caused by impairment of blood supply. The impaired site of blood supply can not be identified even by angiographic and histopathologic examinations in many cases. Therefore, we established experimental models of ischemic colitis by-several methods (Fig. 1). The impairment of blood supply induced various colonic lesions. The colon with the impaired site of blood supply was surgically resected and examined radiologically and macroscopically. The characteristics of macroscopic and radiologic findings of colonic lesions were studied by the two dimensional analysis proposed by Dr. Shirakabe, the three dimensional analysis which included the depth of lesions, and even the four dimensional analysis which included the time course of lesions. We made the "indicators" from the morphological feature of the experimental ischemic colitis. Abnormal barium coating in the radiologic examination and edema in the macroscopic examination were considered to be the morphological features of venous congestion, and erosions were thought to be signs of acutely impaired arterial blood supply. Tubular narrowing and ulcer with thick slough indicated the late phase of impaired arterial blood supply. Angulation, distortion, multiple shallow and longitudinal ulcers with converging folds were signs of the healing stage of impaired arterial blood supply. A coil-shaped deformity of the loop was caused by a mesenteric lesion. Dilatation of the intestinal lumen and a demarcated necrotic pattern were found immediately after the onset of a wide range of impaired blood supply. In conclusion, the impaired region of blood supply and time of onset in each clinical ischemic colitis can be presumed, to some extent, by the morphological features of the "indicators" of the experimental ischemic colitis.

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