David Wallin1,2, David Bock1, Eva Angenete1,2, Lena Öhman3, Magnusson MM3 and Eva Haglind1,2*
1Department of Surgery, Institute of Clinical Sciences, Sweden
2Department of Surgery, Sahlgrenska University Hospital, Sweden
3Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Sweden
Background: Perforated diverticulitis with purulent peritonitis is an uncommon but serious clinical condition requiring emergency surgery. During the last decade laparoscopic lavage has evolved as a new treatment which seems clinically safe. However the mechanisms through which lavage works are unknown and thus improvements of the modality is difficult. An experimental model is needed for clarifying mechanisms and for optimizing the outcome of the lavage treatment. Materials: Sprague-Dawley rats, both sexes, were used. After anesthesia Cecal Ligation and Puncture (CLP) was used and puncture size and time was varied. Samples from abdominal fluid and cecal wall were taken at the end of experiments. Determinations of proteins in abdominal fluid were performed using proximity extension immunoassay and the mouse exploratory panel. Expression of RNA in cecal wall was determined using a PCR Array for Rat Inflammatory Response & Autoimmunity. Results: Puncture through the cecum by 1.2 needle and leaving the animal for 8 h produced macroscopic signs of peritonitis in 8/8 animals. The pattern of inflammatory proteins in abdominal fluid showed a clear separation between CLP and control animals with high values for proteins such as IL1β, IL1α, Cxcl1, TNFα and IL-17A in CLP animals but not in controls. RNA expression in cecal wall tended to cluster separately in CLP and control animals. Conclusion: Cecal ligation and puncture mimicked the clinical condition of perforated diverticulitis with purulent peritonitis. This model can be used to clarify effect or mechanisms triggered by laparoscopic lavage.
Rats; Cecal ligation and puncture; Peritonitis; Abdominal fluid; Protein analyses; RNA expression
Wallin D, Bock D, Angenete E, Öhman L, Magnusson MM, Haglind E. A Model of Cecal Ligation and Puncture Mimicking Perforated Diverticulitis with Purulent Peritonitis. Clin Surg. 2021; 6: 3225..