662 INTESTINAL REPAIR IN CHRONIC PROTEIN-CALORIE MALNUTRITION

Abstract

To assess impact of undernutrition on damaged small intestine we studied repair after ischemia in nutritionally deprived 10 wk rabbits. Rabbits that received 50% of control diet for 6 wks (Body wt, 1.95±0.2 vs control 2.68±.07 kg; p<.001) and underwent sham procedure or 90 min vascular occlusion of 20 cm mid intestine were studied 4 (acute injury), 24, 48 or 72 hr later. In sham groups, no significant differences between diet groups occurred in mucosal dimensions, enzymes (disaccharidases, Na-K-ATPase, thymidlne kinase) or Na transport (Ussing chamber). At 4 & 24 hr, significant but similar abnormalities (reduced villus ht, mucosal enzymes and glucose stim. Na flux) occurred in both diet groups. Subsequent return to normal was not significantly delayed in undernourished rabbits.

We conclude significant chronic nutrient deprivation did not delay repair after injury to limited segment small intestine. Clinical data suggesting prolonged diarrhea in undernourished patients may be explained by a) greater vulnerability of repair to malnutrition after the extensive injury of enteric infection or b) more severe initial injury from infection in undernourished host.

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