J Korean Surg Soc.  2011 Apr;80(4):251-259. 10.4174/jkss.2011.80.4.251.

Migrating motor complex changes after side-to-side ileal bypass in mouse ileum ex-vivo: mechanism underlying the blind loop syndrome?

• Moon SB
• Park KJ
• Moon JS
• Choe EK
• So IS
• Jung SE

• KMID: 1820015
• DOI: http://doi.org/10.4174/jkss.2011.80.4.251

Abstract

PURPOSE
This study was intended to investigate the migrating motor complex (MMC) changes after ileal bypass in ex-vivo mouse models.
METHODS
Partial (side-to-side) and total bypass (occlusion of proximal part of bypassed loop) were performed on ileums of female Institute of Cancer Research mice. After 2 and 4 weeks, the bypassed segments were harvested and MMCs were recorded at 4 different sites ex-vivo. Amplitude, duration, interval, direction of propagation, and the area under the curve (AUC) of MMCs were measured and compared to those of the controls.
RESULTS
In control mice (n = 7), most MMCs propagated aborally (91.1%). After 2 weeks of partial bypass (n = 4), there was a significant decrease in both amplitude and AUC, and orally-propagating MMCs increased significantly (45%, P = 0.002). Bidirectional MMCs (originating in the bypassed loop and propagating in both directions) were also observed (10%). The amplitude of the MMCs remained decreased at 4 weeks after partial bypass (n = 4), and neither the AUC nor the direction of propagation showed significant changes compared to 2 weeks. Similarly, in the total bypass model, both the amplitude and AUC of the MMCs decreased significantly compared to controls. In contrast to partial bypass, 95% of the MMCs within the bypassed loop propagated aborally after 2 weeks (n = 6), which was similar to the control state. After 4 weeks (n = 5), however, MMCs either lost their temporal relationship or completely disappeared.
CONCLUSION
The changes in propagation direction of the MMCs in the partially bypassed loop may contribute to stagnation of bowel contents and the development of blind loop syndrome.

Keyword

Myoelectric complex; Migrating; Mice; Ileum; Jejunoileal bypass

MeSH Terms

Animals
Area Under Curve
Blind Loop Syndrome
Female
Humans
Ileum
Jejunoileal Bypass
Mice
Myoelectric Complex, Migrating

Figure

• 

  Fig. 1 Schematic drawing and operative photograph of the partial bypass model (A) and total bypass model (B). In contrast to the partial bypass model, there were no luminal contents within the bypass loop in total bypass model. As such, the diameter of the bypassed loop tended to be greater in the partial bypass model compared to the total bypass model.

• 

  Fig. 2 Definition of parameters for migrating motor complex. (A) Amplitude and duration of each wave and (B) interval between each wave.

• 

  Fig. 3 Representative traces of migrating motor complexes (MMCs) recorded from the control mice. Dotted lines show the aboral propagation of the MMCs.

• 

  Fig. 4 Representative traces of the migrating motor complexes recorded from the partial bypass for 2 weeks (A, B) and for 4 weeks (C, D). Dotted lines show oral (A, C) or bidirectional (B, D) propagation.

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  Fig. 5 Representative traces of the migrating motor complexes (MMCs) recorded from the total bypass for 2 weeks (A) and for 4 weeks (B, C). (A) MMCs proximal to the anastomosis have no temporal relationship with those within the bypass loop. (B) MMCs lost temporal relationship and (C) regular MMCs were lost within the bypass loop.

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