BACTERIAL TRANSLOCATION IN AN EXPERIMENTAL INTESTINAL OBSTRUCTION MODEL. C-REACTIVE PROTEIN RELIABILITY

Aim: Bacterial translocation occurs in preseptic conditions such as intestinal obstruction. CRP is a marker of ischaemia. Methods: 45 albino male rats were divided into 3 groups (15 each). GI control, GII simple intestinal-obstruction and GIII strangulated obstruction. Outcome measures were: (1) Bacteriologic count typing for intestinal contents, intestinal wall, liver, mesenteric lymph nodes and blood (cardiac portal) (2) Histopathologic: mucosal injury score, inflammatory cell infiltrate in the wall, MLN, liver, (3) Biochemical: serum CRP, IL-10, mucosal stress pattern (glutathione peroxidase- malonyldialdhyde tissue levels). Results: (1) Intestinal obstruction associates with BT precursors (Bact-overgrowth, mucosal-acidosis, immuno-incomptence), (2) Bacterial translocation (frequency density) was found higher in strangulated I.O, that was mainly enteric (aerobic anaerobic) and mostly E.coli, (3) The pathogen commonality supports the gut origin hypothesis but the systemic inflammatory response goes with the cytokine generating one. (4) The CRP median values for GI, II, III were 0.5, 6.9, 8.5 mg/L, for BT +ve 8 mg/L and 0.75 mg/L for BT –ve rats. Conclusion: Bacterial translocation occurrs bi-directional (systemic-portal) in intestinal obstruction and the resultant inflammatory response pathogenesis is mostly 3 hit model. CRP is a reliable marker of BT, BT density and vascular compromise during I.O.