Mucosal Morphology, Bacteriology, and Absorption in Intra-abdominal Ileostomy Reservoir

Six patients who had undergone proctocolectomy and been provided with intra-abdominal ileostomy reservoirs were studied in intervals during the 24 postoperative months. The studies included the mucosal morphology, bacteriology, and the local absorption in the reservoir. The results showed that the mucous membrane of the terminal ileal segment used for construction of the reservoir underwent morphological changes characterized by an increased cell turnover and a shortening of the villi. These changes in morphological structure took place rather promptly after construction of the reservoir. No indications for a continuously progressing process could be found. The brushborder was intact and no cellular lesions were discovered. Soon after construction the reservoir was inhabited by a microbial flora which held an intermediate position between the flora of effluent from conventional ileostomies and normal faeces. The flora remained rather stable in the reservoir. In spite of the new microbial ecology and the morphological changes, the reservoir mucous membrane did retain absorptive capacity for D-xylose and phenylalanine.