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Necrotic enteritis and regional ileitis are recognised causes of sporadic death in pigs. In both conditions, the intestinal mucosa harbours the bacterium, Campylobacter sputorum subsp mucosalis, which was first associated with procine intestinal adenomatosis.
Bile acid absorption was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). By computerizing absorption kinetics the presence of an active transport of glycochenodeoxycholic acid (GCDC) was rendered probable by finding a saturable transport system and a competitive absorption between conjugated bile acids. At the time of investigation 5 patients had no diarrhoea, whereas 6 patients had diarrhoea as defined from the amount of faecal output. In the former group the faecal bile acid excretion was low, the ileal absorption of GCDC high, and judged from the xylose absorption the ileal absorption surface large compared to the latter group, in which the faecal bile acid excretion was high, the ileal absorption of GCDC low, and the ileal absorptive surface small. It is concluded that malabsorption of bile acids in the ileum may be of significant physiological importance in the pathogenesis of diarrhoea in patients with regional ileitis.
Electrolyte and water movement was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). Six patients who at the time of investigation had diarrhoea showed a constant secretion of salts and fluid during perfusion with control perfusate. Per 24 hours, the ileal effluents to colon would exceed the normal amount by 1-2 litres. In the 5 patients without diarrhoea the absorption patterns were normal. Electrolytes and water moved in parallel. Dihydroxy bile acids enhanced secretion or decreased absorption respectively, in the two groups of patients. It is concluded that functional disturbances of salt and water absorption in the inflamed ileum may be of significant physiological importance in the pathogenesis of diarrhoea observed in patients with regional ileitis.
Morphological and histological changes were described in regional ileitis of pigs, which constitutes one of the forms of the complex of diseases referred to as intestinal adenomatosis of pigs. The most pronounced changes were concentrated on the ileum and were characterized, from the morphological point of view, by a distention of the intestinal wall and from the histological point of view, by proliferation of the epithelial cells of ileum, proliferation of the lymphatic tissue of tunica mucosae and submucosae, and hypertrophy of tunica muscularis. This disease has not been described in Czechoslovakia up to now.
A case if ileorectal internal fistula during the course of regional ileitis is described. The clinical course and main forms of surgical managent are illustrated. The clinical, morphological and experimental pathological data indicated that this case should be classed as example of delayed hypersensitivity.
A case of acute segmental inflammation of the terminal ileum in a female patient, who presented with signs and symptoms of acute appendicitis is reported. She had an associated bilateral pulmonary tuberculosis. The role of Mycobacterium tuberculosis in the etiology of the segmental ileal disease, and the relationship of the acute disease of the ileum to Crohn's disease is discussed. Henoch's purpura whose intestinal manifestations may mimic acute regional ileitis is discussed in the differential diagnosis.
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