Langenbeck's Archives of Surgery

, Volume 396, Issue 1, pp 13–29

Intestinal ischemia/reperfusion: microcirculatory pathology and functional consequences

Review Article

DOI: 10.1007/s00423-010-0727-x

Cite this article as:
Vollmar, B. & Menger, M.D. Langenbecks Arch Surg (2011) 396: 13. doi:10.1007/s00423-010-0727-x



Intestinal ischemia and reperfusion (I/R) is a challenging and life-threatening clinical problem with diverse causes. The delay in diagnosis and treatment contributes to the continued high in-hospital mortality rate.


Experimental research during the last decades could demonstrate that microcirculatory dysfunctions are determinants for the manifestation and propagation of intestinal I/R injury. Key features are nutritive perfusion failure, inflammatory cell response, mediator surge and breakdown of the epithelial barrier function with bacterial translocation, and development of a systemic inflammatory response. This review provides novel insight into the basic mechanisms of damaged intestinal microcirculation and covers therapeutic targets to attenuate intestinal I/R injury.


The opportunity now exists to apply this insight into the translation of experimental data to clinical trial-based research. Understanding the basic events triggered by intestinal I/R may offer new diagnostic and therapeutic options in order to achieve improved outcome of patients with intestinal I/R injury.


Perfusion failureLocal inflammationBacterial translocationConditioning maneuversenteral nutrients

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Institute for Experimental SurgeryUniversity of RostockRostockGermany
  2. 2.Institute for Clinical and Experimental SurgeryUniversity of SaarlandHomburg-SaarGermany