RESUMO
AIM: A splenectomy and splenic artery ligation accelerate liver regeneration and improve liver function after a hepatectomy. However, there are no studies that directly compared the effects of a splenectomy and splenic artery ligation. In the present study, we compared the effects of a splenectomy and splenic artery ligation in cirrhotic rats. METHODS: Dimethylnitrosamine (DMN) was administered intraperitoneally for 4 weeks to induce cirrhosis. The rats were divided into three groups: sham operation (CT group), splenic artery ligation (SAL group) and splenectomy (SP group). Liver functions [alanine aminotransferase (ALT) and total bilirubin (T. Bil)], plasma TGF-beta1, histopathological changes, extent of liver fibrosis (fibrotic rate) and regeneration [Ki-67 labelling index(LI)] were investigated in each group. RESULTS: ALT and T. Bil levels were significantly lower in the SP group than the CT and SAL groups. TGF-beta1 levels were significantly lower in the SP group than in the CT and SAL groups. The fibrotic rate was significantly lower in the SP group than in the CT and SAL groups. The Ki-67 labelling index was significantly higher in the SP group than in the CT and SAL groups. DISCUSSION: A splenectomy significantly improved liver regeneration with reduction of plasma TGF-beta1 levels compared with splenic artery ligation in DMN-treated cirrhotic rats.
Assuntos
Cirrose Hepática/cirurgia , Regeneração Hepática , Fígado/fisiopatologia , Esplenectomia , Artéria Esplênica/cirurgia , Alanina Transaminase/sangue , Animais , Bilirrubina/sangue , Biomarcadores/sangue , Proliferação de Células , Dimetilnitrosamina , Modelos Animais de Doenças , Antígeno Ki-67/metabolismo , Ligadura , Fígado/metabolismo , Fígado/patologia , Cirrose Hepática/induzido quimicamente , Cirrose Hepática/patologia , Cirrose Hepática/fisiopatologia , Masculino , Ratos , Ratos Wistar , Fatores de Tempo , Fator de Crescimento Transformador beta1/sangueRESUMO
We report a case of volvulus of the transverse-descending (T-D) colon and megacolon associated with mesenterium commune. A 70-year-old man was referred to our hospital for investigation of severe constipation and abdominal fullness. On physical examination, his abdomen was remarkably distended with generalized tenderness, and weak bowel sounds. Abdominal X-ray showed megacolon at the splenic flexure and a contrast medium enema study showed tapering of the upper rectum. Accordingly, under a diagnosis of T-D colon volvulus, we performed an emergency operation to release the colon volvulus. The intraoperative findings showed a volvulus of the T-D colon with mesenterium commune. The patient recovered uneventfully and his symptoms resolved; however, a postoperative barium enema showed residual megacolon at the splenic flexure.
