Mucosal adaptation changes after urinary diversion

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Mucosal adaptation changes after urinary diversion
Saad Eissa NCI-Cairo University
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• intact junctional complexes.
• prominent filamentous core rootlets, with
  haphazard orientation.

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Altered mitochondrial morphology with dilated
cristae
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increased amounts of intracellular vacuoles
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Solitary, apically located ribosomes were more
abundant in ileal than in colonic mucosa
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Some areas of colonic mucosa were denuded of
microvilli and showed bleb formation.
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Electron-dense particles, lipid depositions,
situated in Golgi apparatus and lying free in the
cytoplasm.
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In summary

• changes that occur in ileal or colonic segments
  of urinary diversion -when they are chronically
  exposed to urine are
• Ileal or colonic Mucosa in contact with urine
  seems to maintain surface characteristics (
  intact desmosomes and tight junctions)
• In ileal mucosa, villi and microvilli were better
  preserved when exposed to urine .
• In colonic mucosa exposed to urine some areas
  were denuded of microvilli and showed blebs.

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• intact tight junctions which indicate that an
  important morphological requirement of maintained
  epithelial barrier function is present in mucosa
  deprived of normal luminal stimulation or after
  contact with urine.
• there were more solitary ribosomes lying free in
  the mucosa exposed to urine, indicating depressed
  or arrested protein synthesis.
• The changes noticed may indicate enterocyte
  adaptation to a new physiologic environment.

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Fortunately, the clinical significance of
electrolyte abnormalities resulting from urinary
diversion through ileal or colonic segments, at
least in the short term, appears to be minimal in
the patient with normal renal function.
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THANKS