Gut Failure and Ischemia / Reperfusion Injury: Ileum or Duodenum? An Experimental Study on Oryctolagus cuniculus

Introduction. Ischemia reperfusion injury following hypoxia/hypoxemia remains a problem in clinic of surgery, referred to a silent leading factor to high morbidity and mortality. Such a condition made an impact to visceral organ in particular gut let its function deteriorated and followed by gut dysfunction and failure shortly, and multisystem organ failure at a later date. It is postulated that ileum is a part of intestine prone to intestinal failure earlier than any other parts, for instance: duodenum. However, available data remains scanty as there no publication found. Thus, we run a preliminary study aimed to find out intestinal damage following artificial ischemia. Method. We run an experimental study on New Zealand White (Oryctolagus cuniculus) (n=7) by induction of ischemia. Ligation of common iliac artery is carried out for 4 hours and let the subjects live in the cage for next 8 hours. The subject is then sacrificed and a full thickness ileum and duodenum is taken through laparotomy. The samples taken referred to the object of histopathology analysis using simple staining of Hematoxylin and Eosin. Villi damage is the main focus of such a study. Such damage is assessed using scoring system based on modified from criteria of Pusponegoro. Results. Of the seven subjects enrolled, the histopathology exams were carried out under light microscope with objective lens magnification of 40 and 100 times. The scores of intestinal villi damage found to be minimal (5.3) compared to ileum (7.4). Conclusion. Histomorphological changes found in both of duodenum and ileum, and severe disconfiguration of intestinal villi found in the ileum. J I Bedah Indones. 2015;44:10-13.