Liver Injury following Intestinal Ischemia-reperfusion Demonstrated by 3’p Magnetic Resonance Spectroscopy in Vivo

Introduction Intestinal ischemia-reperfusion (IR) injury is one of the most serious surgical conditions in paediatrics. Neonates may suffer necrotising enterocolitis (NJ% intussusception, midgut volvulus and strangulated intestinal hernia. The most common cause of morbidity and mortality in necrotising enterocolitis is multiple organ failure, especially involving the liver. It has been demonstrated that intestinal IR activates the release of inflammatory mediators and promotes leukocyte-endothelial cellular adhesion. Generalised microvascular injury is produced in both local and remote organs (1). A rat model of intestinal IR created by occluding and deoccluding the superior mesenteric artery has been used in several centres to study the pathophysiology of this condition, and a previous study of liver metabolites from our group by 31P MRS in vitro showed that 90 min of intestinal ischemia followed by 60 min of intestinal reperfusion significantly affected hepatic energy metabolism (2).