After a surgically induced partial obstruction of the small intestine (ileum) in adult rats there is an accumulation of ingesta and a progressive enlargement of the lumen accompanied by wall thickening : over a period of 2-3 wk the circumference of the hypertrophic intestine increases by a factor of 2n7 and the thickness of the musculature increases more than threefold, while the length of the ileum (measured at the mesenteric attachment) remains unchanged. The villi become markedly larger and more elongated in the circumferential direction, and have a greater separation between one another. The number of villi per unit surface is markedly reduced but the number of villi per unit length of ileum, whilst appearing to show a small increase, was not significantly altered. The component epithelial cells (absorptive cells) appear unchanged in morphology and size (height). The microvilli of the epithelial cells have the same appearance, size (height) and packing density in the control and the hypertrophic ileum. Glands of Lieberku$ hn, Peyer's patches and single lymphatic follicles constituting the Peyer's patches are significantly increased in size in the hypertrophic intestine. The serosal surface of the hypertrophic ileum, in spite of the great expansion, remains regularly covered by mesothelial cells ; these are much larger than in the controls and have an altered distribution of their microvilli.Key words : Intestinal villi ; microvilli ; Peyer's patches ; mesothelium ; hypertrophy ; intestinal obstruction.
When the flow of ingesta along the small intestine is impaired, as in the presence of a localised partial obstruction of the lumen, the intestine on the oral side of the obstruction becomes distended and hypertrophic. Enlargement of the lumen and distension of the wall are mechanical effects of the accumulation of ingesta. In contrast, hypertrophy is an active process of growth of the intestinal wall, mainly the musculature, the effect of which is that the wall, in spite of being very distended, is not thinner than in controls but conspicuously thicker. The occurrence of ileal hypertrophy, its relevance to medical conditions (such as obstructions due to pathologic growths or malformations), its scientific significance as a process of growth and adaptation of mature tissues, have been known for a long time. Herczel (1886) was probably the first to describe the structure of hypertrophic intestine, and the process has been analysed in Correspondence to Dr