Gastroenterologia ]aponica Copyright (p~ 1989 by The Japanese Society of Gastroenterology
Vol. 24, No. 2 Printed in Japan
Rapid Conmmnication ]
The analyses of intestinal microcirculation arterial media in ~ ' s disease
Yuji FUNAYAMA, Iwao SASAKI, Kohei FUKUSHIMA, Hiroo NAITO, Yasuhiko KAMIYAMA and Seiki MATSUNO First Department of Surgery, Tohoku University School of Medicine, Sendai 980, Japan
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 vascular resistance and plays an 0,~m, O(pm) I important role in ulcerogenesis in ,00 lOO Crohn 's disease. References 1.Hult~n L,Lindhagen J,Lundgren O, I0 et al:Regional intestinal blood flow in ulcerative colitis and Crohn's disease.Gastroentrology 1 977; 72: 388/ R(urn~ R(gml 396 10 100 1000 10 100 1000 2.Suwa N, Takahashi T :Morphological Type I Type II a n d m o r p h o m e t r i c a l a n a l y s i s of circulation in hypertension and R:Radius, D:Diameter of arteries ischemic kidney. Munchen,Urban and (fine lines :controls, bold lines :CD) Schwarzenberg, 1971 lower left lines :submucosa upper right lines :mesenterium in each figure.
Received February 3, 1989. Accepted February 17, 1989. (Gastroenterol]pn 1989;24:223) Address for correspondence: Yuii Funayama, M.D., The First Department of Surgery, Tohoku University School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai 980, Japan.