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Murine Ileocolic Bowel Resection with Primary Anastomosis
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Lymphatic network remodeling after small bowel resection.

Emily J Onufer1, Rafael Czepielewski2, Kristen M Seiler1

  • 1Division of Pediatric Surgery, Department of Surgery, St. Louis Children's Hospital, Washington University in St. Louis School of Medicine, St. Louis, MO.

Journal of Pediatric Surgery
|March 19, 2019
PubMed
Summary
This summary is machine-generated.

Short gut syndrome (SGS) after small bowel resection (SBR) alters intestinal lymphatics. Remodeling of mesenteric and mucosal lymphatic vessels may impair lipid transport and contribute to SGS complications.

Keywords:
AdaptationIntestinal failureLymphaticsRemodelingShort gut syndromeSmall bowel resection

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Area of Science:

  • Gastroenterology
  • Vascular Biology
  • Pediatric Surgery

Background:

  • Short gut syndrome (SGS) is a critical condition in children following massive small bowel resection (SBR).
  • Nutritional deficiencies and liver steatosis are common complications, partly due to impaired fat absorption.
  • The role of lymphatic vasculature in SGS pathogenesis remains understudied.

Purpose of the Study:

  • To investigate the impact of SBR on intestinal lymphatic vasculature integrity and structure.
  • To determine if lymphatic remodeling contributes to impaired lipid transport in SGS.

Main Methods:

  • Mice underwent 50% proximal small bowel resection (SBR) or sham operations.
  • Lymphatic vasculature in the lamina propria and mesentery was imaged.
  • Gene expression of lymphangiogenic markers was analyzed.

Main Results:

  • SBR significantly altered mesenteric lymphatic collecting vessels, leading to new branching and loss of valves.
  • Mucosal lymphatic capillary area in the distal ileum decreased post-SBR.
  • Intestinal Vegfr3 expression increased significantly in mice after SBR.

Conclusions:

  • Intestinal lymphatic vessels undergo dramatic remodeling after SBR.
  • This remodeling may compromise lymphatic flow and function.
  • Altered lymphatics could contribute to the nutritional deficiencies and morbidities associated with SGS.