Some features of the pathogenetic mechanisms of the development of acute adhesive small bowel obstruction

Abstract

Aim . To study the pathogenetic mechanisms of the development of acute adhesive small bowel obstruction. Material and methods . An analysis is given of the results of a comprehensive examination of 50 patients with acute adhesive small bowel obstruction. In 46 (92%) observations out of 50 (100%) patients, the causes of acute adhesive small bowel obstruction were various pathologies of the abdominal cavity organs, which had a history of diff erent types of surgery and volume of surgical interventions, and in 4 (8%) cases it was primary, without carrying out surgical interventions. Results . The results of the study showed a signifi cant decrease in the level of serotonin in biopsies of the mucous membrane of the small intestine and in the blood serum with the progression of oxidative stress and cytokine activity in patients with acute adhesive small bowel obstruction, who had a history of various surgical interventions on the abdominal and pelvic organs, and there were also infl ammatory processes in the small intestine. This leads to disruption of the motor function of the small intestine, the development of intestinal paresis. Depending on the extent of the lesion and the occurrence of pathomorphological changes in the walls of the small intestine, single or multiple viscero- visceral and viscero- parietal adhesions are subsequently formed with the development of acute adhesive small bowel obstruction. Conclusion . Thus, in the pathogenesis of acute adhesive small bowel obstruction, the leading place is given to a decrease in the number and qualitative composition of EC-cells of the small intestine mucosa producing serotonin due to oxidative stress and cytokine activity.