Summary: Changes in the morphofunctional organization of the liver in acute small bowel obstruction, leading to the development of acute hepatic insufficiency, have not been adequately studied. The aim of the work is to identify the patterns of the dynamics of changes in the morphofunctional organization of the liver vasculary bed and their relationship to changes in the energy metabolism level of the liver at different times of acute strangulation small bowel obstruction development.
Materials and Methods:The study was carried out on 23 adult mongrel dogs of both sexes weighing 17 -20 kg. The study of the normal liver morphology was performed on 3(three) dogs, which served as the first control group. Modelling of strangulational bowel obstruction was performed on the animals of the second group (12 animals) with excision of liver pieces for observation periods of 3, 6, 12 and 24 hours.The third control group was consisted of 8 animals, whose liver morphology was studied after laparotomy without intervention on the vessels and organs of the abdominal cavity. The sampling of the material for the study was carried out over 3, 6, 12 and 24 hours following the laparotomy. Comparison of the study results in the second and third groups allows revealing changes in the liver caused by acute small bowel obstruction, but not the consequences of laparotomy when modeling the disease.A morphometric method for estimating the change in the volume of liver's vascular bed was used for departments (arterial part of the liver's Hemomicrocirculatory Bed (HMCB), capillary and venous part), the samples were stained with hematoxylin and eosin. To assess the change in the energy metabolism level, a method was used to quantify the glycogen content by the results of the Schiff (PAS) reaction.
Results:We revealed patterns of changes in the morphofunctional organization of liver's vascular bed and the correlation between changes in the area (and consequently, the volume) of the vascular bed and changes in the energy consumption level in the dynamics of development of acute strangulational small bowel obstruction.
Conclusion:The changes in the liver hemocirculatory bed revealed by us are characterized by the development of compensatory vasodilatation of the arterial and venular link of the HMCB with a decrease in the glycogen level at the initial time (3 hours) and at the end of the experiment (24 hours). This is due, in our opinion, to an increase in the venous blood supply through the portal vein saturated with toxic products, which requires an increase in energy consumption for the performance of detoxifying function. With a decrease in the area of interlobular veins and a decrease in toxic effect, the glycogen level was increasing. The arterial blood supply remained elevated at all times of the experiment, due to the high demand of the liver for oxygen. We have revealed a strong inverse correlation between the change in the vascular bed area and the energy metabolism level.