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[MORPHOLOGICAL CHANGES IN THE SMALL INTESTINE ASSOCIATED WITH STRANGULATION OF MECHANICALLY OBSTRUCTED BOWEL].

AIM
To estimate the degree and prevalence of pathomorphological changes in the small intestine at different distances from the visible necrosis boundary depending on acute mechanical obstruction for the choice of the optimal extent of resection.


MATERIALS AND METHODS
Small intestine fragments for morphological study were obtained from 52 patients aged 17-83 (mean 47 ± 17) years after emergency resection of mechanically obstructed necrotic bowel. Strangulation caused by obstructive adhesion was diagnosed in 48%, constricted hernia in 38.5%, torsion in 13.5% of the cases. Tissue morphology was studied by histological staining and light microscopy at 5 cm intervals between the sections.


RESULTS
The degree and prevalence of pathomorphological changes in the small intestine depended on the severity of obstruction and increased with its decompensation.


CONCLUSION
The extent of resection in proximal and distal directions from the visible boundary of necrosis must be chosen on an individual basis depending on the degree of compensation of mechanical intestinal obstruction. The absence of extensive resection especially in the proximal direction allows to reduce the frequency of short bowel syndrome with malabsorption in the late postoperative period.