MORPHOLOGICAL CHANGE OF LIVERS IN EXPERIMENTAL ACUTE NARROW-NECKED OBSTRUCTION

Since clinical studies do not allow to properly track the morpho-functional stages of the development of the pathological process in various organs and systems in patients with Acute Narrow-Necked Obstruction (ANNO) and to introduce new effective approaches to the treatment and prevention of complications, there is a need to create an adequate experimental model of the disease in animals. For the purpose of comprehensive study of morpho-functional changes in the liver and small intestine in the dynamics of ANNO development, an experimental study was con-ducted on 40 animals (Vietnamese breeds of swine, aged 3-4 months weighing 15-20 kg based on the vivarium of the SHEI "Ternopil State Medical University named after. I.Ya. Gorbachevsky "). The reason for the choice of animals was that the pig's small intestine is best suited for the simulation of surgical diseases, while the data obtained can be extrapolated to a certain extent to a person For purity of the experiment, ANNO was modeled by the laparoscopic method using the technique A. Shalimova. (1989). Leaving 50 cm from the ileocecal angle to the loop of the gut, together with the flea lavsan thread, the ligation was applied so that the dissoctor passes between the intestine and the thread without any difficulty. This was necessary to ensure that in the place of compression of the lumen of the intestine there was no necrosis of the intestine due to a violation of local blood circulation. Cases of insufficient compression or necrosis of the site of obturation of the gut in this method were not observed. All animals were divided into 4 groups. And 1gr - animals with ANNO (n = 17) - animals weighing 16.5 ± 1.0 kg, which were treated in accordance with the general scheme and restored intestinal obstruction in 12-72 hours; II gr. - animals with ANNO (n = 18) - animals weighing 16.5 ± 0.9 kg, which were combined with the addition of conventional antihypoxant-antioxidant and hepatoprotective therapy and restored intestinal obstruction in 12-72 hours; III gr. - the flow of ANNO without restoring its patency (n = 5) - animals weighing 16.7 ± 1.0 kg that were observed in the dynamics of the course of simulated intestinal obstruction during 72 hours of the disease. Surgical interventions (laparotomy, ANNO modeling and subsequent treatment) were performed under general anesthesia. On the day of the operation and in the first three days of the postoperative period, animals were given 2 ml of 50% solution of analgin twice a day for the purpose of analgesia. The experiment carried out a pathological study of liver cells. The complex examination of animals was carried out at 5-7 and at 12-14 days of treatment. By analyzing the morpho-functional state of the liver under experimental narrow-neck obstruction, it can be summarized that dystrophic changes in hepatocytes in ANNO are polymorphic and indicate in the early stages of the experiment the functional stress and activation of compensatory mechanisms. With the prolongation of the trial, the manifestations of hydropic dystrophy signaled the failure of the adaptive capacity of hepatocytes, which in part of the cells passed into necrotic. Flushing and stasis showed a violation of the rheological properties of the blood. Polymorphic-cell infiltration of not only portal tracts, but also intracellular, points to the inflammatory component in the course of the process. Separately, it should be emphasized the increase in the number of dual-core hepatocytes, which may be due to the deployment of regenerative processes in the liver. As the duration of impassability increases, pathomorphological deviations in hepatocytes often become irreversible. The conducted biopsy study of the liver in animals showed an increase in the degenerative and destructive processes in the liver tissue, depending on the time of development of intestinal obstruction, which correlated with the severity of EI.