Bacterial Translocation is Favored by the Preservation of the Ileocecal Valve in Experimental Short Bowel with Total Parenteral Nutrition

Abstract

Sepsis in short-bowel syndrome (SBS) is in part due to bacterial translocation (BT). Parenteral nutrition (PN) is often necessary in SBS and promotes BT. The aim of this study was to asses the effect of the presence or absence of ileocecal valve (ICV) on BT in parenterally-fed rats with massive intestinal resection. Sixty-five adult Wistar rats underwent central venous cannulations and were randomly assigned to one of five groups receiving for ten days five treatment regimes: Sham (n = 17) standard rat chow + i.v. saline. PN (n = 17) fasting + PN. Res-Sham (n = 10) standard rat chow + i.v. saline + 80% gut resection. Res-PN (n = 11) fasting, PN + 80% gut resection. Res-ICV-PN (n = 10) fasting, PN + 80% gut resection including ICV. At the end of the experiment they were euthanized and mesenteric lymph nodes (MLN), spleen and peripheral and portal blood specimens were recovered and cultured. BT was found in 47% of PN animals, 91% of Res-PN rats, 100% of Res-Sham group and 60% of Res-ICV-PN animals, but not in Sham ones. 97% of BT+ animals had positive cultures in MLN and/or portal blood, whereas germs beyond liver were detected in 30% of Res-Sham, 37% of PN, 50% of Res-PN and 0% of Res-ICV-PN rats. The present study confirms that both massive intestinal resection and PN promote BT. In addition, it shows that animals deprived of ICV have lower incidence of BT in this setting than those with it and that the germs do not reach in them peripheral blood in the same proportions as in ICV-intact animals. These results suggest that the presence of an intact ICV favor BT in parenterally-fed rats with massive intestinal resection.

Surgical Anatomy Does Not Affect the Progression of Intestinal Failure–Associated Liver Disease in Neonatal Piglets

“…Increased bacterial translocation to the lymph nodes and portal blood has previously been observed in resected rodents compared with nonresected, although those rodents were fed enterally. A prior study in adult Wistar rats also found increased bacterial translocation in gut‐resected animals, whether enterally or PN fed . Interestingly, that study also found that PN‐fed rats without the ICV had reduced bacterial translocation compared with those with the ICV.…”

Effects of Insulin-Like Growth Factor-1 on Short Bowel Syndrome without Ileocecal Valve in Rats

“…With the intact ICV, fewer patients required PN, the time of weaning from PN was shorter, and the number of patients weaned was larger [10]. However, recent experimental studies demonstrated that additional resection of ICV to SBR significantly decreased the incidence of bacterial translocation with the explanation that prolongation of the intestinal transit time by ICV might play a role in the 'bacterial translocation' [13,14]. Our study presented crucial effects of ICV on short bowel syndrome.…”

The ileum positively regulates hepatic regeneration in rats

“…In several animal models it has been demonstrated that bacterial translocation to the mesenteric lymph nodes, liver and spleen is increased after intestinal resection [18][19][20] . Although in this study we have not studied bacterial translocation, it is speculated that the mechanism for this to occur is not yet known, but hardly is secondary to simple changes in intestinal permeability after ileal resection 21 .…”