Vascular anatomy of the small intestine—a comparative anatomic study on humans and pigs
- 512 Downloads
Porcine models are well established for studying intestinal anastomotic healing. In this study, we aimed to clarify the anatomic differences between human and porcine small intestines. Additionally, we investigated the influences of longitudinal and circular sutures on human small intestine perfusion.
Intestines were obtained from human cadavers (n = 8; small intestine, n = 51) and from pigs (n = 10; small intestine, n = 60). Vascularization was visualized with mennige gelatin perfusion and high-resolution mammography. Endothelial cell density was analyzed with immunohistochemistry and factor VIII antibodies. We also investigated the influence of suture techniques (circular anastomoses, n = 19; longitudinal sutures, n = 15) on vascular perfusion.
Only human samples showed branching of mesenteric vessels. Compared to the pig, human vessels showed closer connections at the entrance to the bowel wall (p = 0.045) and higher numbers of intramural anastomoses (p < 0.001). Porcine main vessels formed in multifilament-like vessel bundles and displayed few intramural vessel anastomoses. Circular anastomoses induced a circular perfusion defect at the bowel wall; longitudinal anastomoses induced significantly smaller perfusion defects (p < 0.001). Both species showed higher vascular density in the jejunum than in the ileum (p < 0.001). Human samples showed similar vascular density within the jejunum (p = 0.583) and higher density in the ileum (p < 0.001) compared to pig samples.
The results showed significant differences between human and porcine intestines. The porcine model remains the standard for studies on anastomotic healing because it is currently the only viable model for studying anastomosis and wound healing. Nevertheless, scientific interpretations must consider the anatomic differences between humans and porcine intestines.
KeywordsBowel perfusion Porcine anatomy Human anatomy Anastomotic healing
- 1.Federal Statistical Office (2004) Health-medical costs 2002. Federal Statistical Office—Press Office WiesbadenGoogle Scholar
- 2.Federal Statistical Office (2004) Diagnosisdata of hospital patients 2002. Federal Statistical Office—Pressoffice WiesbadenGoogle Scholar
- 7.Press Office Helios clinics—Fulda (2002) Helios Kliniken Gruppe Kompetenz in Medizin. Annual medical report 2001Google Scholar
- 15.Lang J, Heichele J (1982) Über die Gefäße des Dünndarms. Morphol Med 2:207Google Scholar
- 18.Michels NA, Siddhardt P, Kornblith PL, Parke WW (1963) The variant blood supply to the small and large intestines: its import in regional resections. J Int Coll Surg 39:127–170Google Scholar
- 31.Pargger H, Staender S, Studer W, Schellscheidt O, Mihatsch MJ, Scheidegger D, Skarvan K (1997) Occlusive mesenteric ischemia and its effects on jejunal intramucosal pH, mesenteric oxygen consumption and oxygen tensions from surfaces of the jejunum in anesthetized pigs. Intensive Care Med 23:91–99CrossRefPubMedGoogle Scholar
- 37.Sommerova J (1980) Contribution to the comparative anatomy of jejunoileal arcades in mammals. Folia Morphol (Praha) 28:282–285Google Scholar
- 40.Schummer A, Wilkens H, Vollmershaus B, Habermehl KH (1981) The anatomy of domestic animals. Parey, BerlinGoogle Scholar