Effect of methylene blue on intra-abdominal adhesion formation in rats

Adhesion formation represents an important clinical challenge in gastro-intestinal surgery. In the late era, methylene blue [MB] has been claimed to play a helping role in combating such a problem. In the present study, we investigated the effects of MB administered intraperitoneally on the surgically-induced adhesions in rats and tried to clarify whether its impact is concentration-dependent. Seventy adult male Wistar rats were used. They were allocated into seven groups, ten rats each: one control two sham - operated and four experimental ones. Peritoneal adhesions were evoked by scraping the cecal serosa in the four experimental groups which were given different concentrations of MB, intraperitoneally. The animals of the control group were similarly dealt but were given saline. The rats of the sham-operated groups were given either MB or saline but without any serosal damage. After the elapse of two weeks, the resulting adhesions, inflammation and fibrosis were evaluated. In the rats treated with MB 1%, adhesions, inflammatory process and fibrosis scores were similar to those in the sham-operated rats and were significantly lower than those in all other groups. It could be concluded that MB, 1%, had the best anti-adhesion potential

Surgical treatment of the pilonidal disease - primary closure or flap reconstruction after excision

Controversy still exists regarding the best surgical technique for the treatment of pilonidal disease in terms of recurrence rate and patient discomfort. The present study analyses the results of excision with primary closure and excision with flap reconstruction in the surgical treatment of sacrococcygeal pilonidal disease. From January 2003 to January 2006, 60 consecutive patients with primary pilonidal sinus disease received surgical treatment in the form of either excision and primary closure [group 1,20 patients] or excision and flap reconstruction [group II, 40 patients: 20 with modified Limberg flap, 10 with classical Limberg flap and 10 with adipo-fascio-cutaneous flap]. Times for complete healing and return to work were recorded. To evaluate patient comfort, all patients were asked to complete a questionnaire including visual analogue scale, time to sitting on toilet without pain, and time to walking without pain 3 months after surgery. Mean follow-up was 21 months. There was a significant difference between the two groups in terms of length of hospital stay [P <0.003], time to complete healing [P < 0.001], time off work [P < 0.001], wound infection and recurrence rates [P <0.01], times to sitting on toilet without pain [P < 0.002], and walking without pain [P < 0.001]. The mean postoperative visual analogue scale scores were 6.1 +/- 1.2 in primary closure group versus 7.4 +/- 1.3 in flaps groups [P < 0.001]. In the modified Limberg flap, there was no wound infection, no wound breakdown and no recurrence of the disease. Flaps reconstructions are superior to primary closer after excision of pilonidal sinus and that modified Limberg flap is far better as regards wound infection and recurrence

light and scanning electron microscope study of the albino rat ileum after its partial obstruction

Induction of some sort of obstruction could be resorted to as a definitive line of management of some cases of short- bowel syndrome [SBS]. The goal of this study was to clarify the histological and morphometric alterations in the albino rat ileum after its surgically induced partial obstruction. Thirty adult male albino rats [240-250 gm] were used in this investigation. They were divided into two equal groups: control and experimental. Small pieces of the ileum of the control and experimental animals were processed for histological and scanning electron microscope study. The ileum of the experimental animals proximal to the site of obstruction showed an apparent enlargement in the Peyer's patches and an increase in the thickness of both the mucosa and muscle layers. The villi showed significant elongation and thickening. Both widening and deepening of the crypts were detected. There were an apparent increment in the goblet cell number and in the lymphocytic infiltration in both the corium and submucosa. Scanning electron microscopic examination, the microvilli showed scattered areas of shortening and irregular orientation. The surface was more frequently broken by goblet cell orifices. It could be concluded that partial ileal obstruction resulted in hypertrophy of the ileal wall with considerable structural alterations oral to the obstruction site. Thus, a procedure apparently increased the absorptive surface area together with slowing the intestinal transit. These effects could support putting forward this technique into consideration as one of the suggested lines of treatment of some cases of short bowel syndrome to eliminate the patients need for the parenteral nutrition and all its associated complications

Effect of reperfusion after haemorrhagic ischaemia on the rat jejunal villi

This study was done to evaluate the ischaemtic lesions in the rat jejunal villi and the effect of allopurinol on such lesions, after the induced haemorrhagic shock. Thirty-five adult rats [200-250gm] were used. They were arranged into three groups, the first which [5 rats] served as a control while the remaining two [A and B 15 rats each] were utilized in the experiment. The rats in the experimental groups were anaesthetized with pentabarbital sodium and through the femoral vein 30 ml/kg of blood were withdrawn in a sterile heparinized syring and left for 2 hours then reinfused again. The rats of group B were given 50 mg / Kg allopurinol after blood withdrawal. The same dose was injected daily untill sample collection. Five rats from each experimental group were sacrificed 2 hours, 48 hours and five days after blood reinfusion, in succession. Samples from the jejunum were taken and processed to obtain Hx, E stained paraffin sections as well as ultrathin sections for E/M study. A loop of jejunum was opened and its mucosa was scraped, weighed, minced and homogenized in phosphate buffer [pH 7.4] and the supernatant was analyzed for the level of malondialdehyde [MAD] in the jejunal mucosa. The height of jejunal villi, the number of goblet cells over them as well as the level of [MDA] in the experimental groups were statistically analyzed for the test of significance as compared to the control. There was a significant shortening of jejunal villi, a concomitant decline in goblet cell number over them in the animals of group A compared to control. There was also a significant elevation of [MDA] level in group A as compared to the control. The hight of jejunal villi, the goblet cell number and the level of [MDA] in group B showed no significant changes when compared to control. Two hours after blood reinfusion, in group A, the tips of jejunal villi got broad and their covering cells became short with pyknotic nuclei. The underlying lamina propria showed subepithelial spaces and lymphocytic infiltration. The microvilli on the surface of absorptive cells were short, distorted and lacked their filamentous coat. There was also dilatation of rough and smooth endoplasmic reticula and swelling of mitochondria which possessed disrupted cristae. After 48 hours there were extensive mucosal lesions manifested as sloughing of the degenerated epithehum on the tips and lateral sides of the villi, while the lamina propria lodged wider subepithelial spaces, marked lymphocytic infiltration and haemorrhage, in some areas The absorptive microvilli were noticeably distorted while the cytoplasm contained markedly dilated endoplasmic reticulum, small distorted mitochondria, lysosomes and cytoplasmic vacuoles. Five days after blood reinfusion, in group A, the jejunal villi became denuded and some of them remained as ghosts. The lumen of the jejunum contained detached villi and necrotic materials. There were also marked necrosis and disintegration of the lamina propria. The remaining adsorptive cells lost their microvilli and their cytoplasm was disintegrated with distorted organdies, many vacuoles and lysosomes. After allopurinol treatment, in group B, the light and electron microscopic features of the jejunal villi and their covering cells were more or less similar to the control except for some lymphocytic infiltration. It could be concluded that the destructive effects of blood reinfusion in haemorrhagic shock on the jejunal villi could be alleviated by allopurinol administration