[An experiment of gut barrier function damage following multiple firearm injuries in a porcine model]

To study the characteristics and pathogenesis of gut barrier damage following multiple firearm injuries in porcine models.

24 small pigs were divided into 4 groups (n = 6 each): control group(group C), group H (gunshot-induced tangential fracture of parietal bone), group L (gunshot-induced comminuted fracture of bilateral femora) and group M (combined group H + L). Gastric intramucosal pH (pHi), plasma endotoxin in portal vein, and plasma D-lactic acid were measured and blood samples were cultured at different time intervals after trauma. The animals were sacrificed at 72 h and ileum tissues were harvested for pathological examination and DAO measurement.

In group M at 72 h, pHi was significantly lower than that of group H and L(P < 0.01), plasma endotoxin level was significantly higher than that of group H(P < 0.01) and group L(P < 0.05), D-lactic acid level was significantly higher than that of group H(P < 0.01), and bacterial isolation rate in blood was much higher than that of group H and L(P < 0.05). Necrosis and peeling off were revealed at ileum villus top in all trauma groups, especially in group M, in which ileum DAO content also declined in most cases.

Multiple traumas were prone to gastrointestinal ischemia even when hemorrhagic shock did not take place. The damage of gut barriers in multiple traumas were more severe than that in one-site trauma, which enhanced the incidence of intestinal endotoxin and bacterial translocation and trend to cause enterogenous infection.