The analyses of intestinal microcirculation by histometrical studies of arterial media in Crohn's disease.

Abstract

On the assumption that the ulcerogenesis in Crohn's disease (CD) is closely linked with ischemia(1 ), the vascular changes of resected specimen of eighteen cases of CD were investigated using histometry(2) of arterial media. The regression lines, made by arterial radius and thickness of media to investigate the pattern of vascular reaction in each case, could be classified into two groups. In 11 cases of type I group, the thickening of media, suggesting the appearance of vascular resistance, was shown in the distal mesenteric arteries. On the other hand, in seven of type II group, the atrophy of media was observed in the mesenteric arteries , suggesting the vascular resistance exists in upper stream arteries. Type I was seen in four cases of ileocolic type, three cases of large bowel type and four cases of small bowel type. On the contrary, type II consisted of six cases of ileocolic type and one case of large bowel type, which suggested that type II group was characterized by the cases of extensive disease. Therefore type II was thought to be the modified form of type I by more advanced vascular change. In peripheral arterioles the atrophy of media was observed in both types. These changes were observed even in disease-free areas. These results suggest that the ischemia is formed by mesenteric Changes of the regression lines in Crohns disease