RESUMEN
AIM: To describe colon anatomy with colonoscopy and computed tomography (CT) to develop a rat model for future studies of therapeutic colonoscopy. METHODS: Eighteen male Sprague-Dawley rats, on average 400-420 g, underwent total colonoscopy, CT and histological examination. Colonoscopy was performed after bowel preparation with a baby upper gastrointestinal endoscopy with an outer diameter of 6.7 mm. CT obtained a 3D image of total colon after a rectal enema with radiological contrast. Macroscopic and microscopic examinations were examined with a conventional technique (hematoxylin and eosin). Colonic wall thickness, length and diameter measurements were taken from the anus, 3, 7, 14 and 20 cm from the anal margin. RESULTS: The median colonoscope depth was 24 cm (range 20-28 cm). Endoscopic and tomographic study of colon morphology showed an easy access with tubular morphology in the entire left colon (proximal left colon and rectum). Transverse colon was unapparent on colonoscopy. Right colon, proximal to the splenic flexure, was the largest part of the colon and assumed saccular morphology with tangential trabecula. Radiological measurements of the colonic length and diameter substantiate a subdivision of the right colon into two parts, the cecum and distal right colon. In addition, histological measurement of the colonic wall thickness confirmed a progressive decrease from rectum to cecum. The muscular layer was thinner in the proximal left colon. CONCLUSION: The combination of colonoscopy, tomography and histology leads to a better characterization of the entire colon. These data are important for deciding when to perform endoscopic resections or when to induce perforations to apply endoscopic treatments.
RESUMEN
BACKGROUND: Quality bowel preparation is essential to examine the entire colon adequately. No trials comparing different purgative regimens are available in animal models. The aim was to compare 5 methods for bowel cleansing to develop a rat model to study therapeutic colonoscopy. METHODS: Twenty-five rats were assigned to one of 5 regimens: (1) high-volume polyethylene glycol electrolyte solution (HV-PEG-ES, 40 mL); (2) low-volume PEG-ES (LV-PEG-ES, 20 mL); (3) high-volume PEG-ES+ascorbic acid (HV-PEG-ES+AA, 20 mL); (4) LV-PEG-ES+AA, 10 mL; (5) rectal enema with saline solution (RE-SS). Bowel preparation quality was rated by total colonoscopy. RESULTS: RE-SS is the best regime for left colon cleansing, whereas HV-PEG-ES and HV-PEG-ES+AA solutions resulted in significantly better cleansing in the whole colon. HV-PEG-ES+AA regimen needed less volume, and administration was easier. CONCLUSIONS: A total of 20 mL of PEG-ES+AA before colonoscopy is the best regimen to explore the whole colon, whereas to explore the left colon RE-SS is adequate.
Asunto(s)
Ácido Ascórbico/farmacología , Catárticos/farmacología , Colonoscopía/métodos , Electrólitos/farmacología , Polietilenglicoles/farmacología , Animales , Ácido Ascórbico/administración & dosificación , Catárticos/administración & dosificación , Esquema de Medicación , Electrólitos/administración & dosificación , Enema/métodos , Intubación Gastrointestinal , Masculino , Polietilenglicoles/administración & dosificación , Distribución Aleatoria , Ratas , Ratas Sprague-DawleyRESUMEN
BACKGROUND: Bacterial infections are frequent in cirrhosis. Experimental studies suggest a pathogenic role of intestinal bacterial translocation in them. Both fermentable and non-fermentable fibre avoided intestinal bacterial translocation (IBT) in animal models of gut starvation and critical illness. AIM: To assess the effect of fermentable (pectin) or non-fermentable (lignin) fibre on IBT in ascitic cirrhotic rats. METHODS: Thirty-six rats induced to cirrhosis with oral CCl4 were randomized (6 weeks after the first CCl4 dose) to receive rat chow+5% lignin (LIG, n=13), rat chow+5% pectin (PEC, n=13), or rat chow only (CON, n=10). Once ascites developed, animals were laparotomized and samples of mesenteric lymph nodes (MLN), ascitic fluid, portal and peripheral blood and liver, were obtained for culture. RESULTS: IBT rate was: LIG=5/13, PEC=4/13, CON=5/10 (P=N.S.). The median amount of translocated bacteria in rats with IBT was lower in the PEC group (2 x 10(2) CFU/g MLN), than in LIG (10(5) CFU/g MLN) and CON (10(4) CFU/g MLN) groups (P<0.05). All other samples were sterile except for a portal blood sample (Enterococcus faecalis) of the LIG group. CONCLUSIONS: IBT incidence is not decreased by either pectin or lignin in ascitic cirrhotic rats, but pectin supplementation reduces the amount of translocated bacteria.