ISSN 2398-2969      

Intestine: villus atrophy

icanis

Introduction

  • Villus atrophy refers to damage to the villus particularly involving the tip where the most mature absorptive cells reside.
  • Cause: dietary factors, eg gluten, viral, bacterial and Giardial infections, prolonged starvation, parenteral nutrition, inflammation/neoplastic disease.
  • Signs: maldigestion and malabsorption, chronic diarrhea and weight loss → increased borborygmus.
  • Diagnosis: endoscopy, biopsy and histopathology.
  • Treatment: fluid therapy, diet modification.
  • Prognosis: generally good.

Pathogenesis

Etiology

  • Viral or Giardial damage to the cells of the villus.
  • Gluten sensitivity results in infiltration of inflammatory cells and villus atrophy.
  • Secondary to inflammation or infiltration of neoplastic cells.

Specific

  • Parvoviral, coronaviral or Giardial infection.
  • Gluten sensitivity.

Pathophysiology

  • The villus is the functional unit of the small intestine.
  • There are many hundreds of thousands of these units within the small intestine.
  • They are responsible for final stages of digestion and absorption of food.
  • Coronavirus Canine coronavirus invades and damages cells on the villus tips → villus atrophy.
  • Parvovirus Canine parvovirus invades and destroys cells in the crypts of Leiberkhuns. This prevents the migration of new cells up the villus and consequently failure of the villus and severe villus atrophy.
  • Gluten sensitivity results in inflammatory bowel disease Inflammatory bowel disease: overview especially involving the proximal intestine. villus atrophy is a feature of this inflammation.
  • Intestinal inflammation/neoplasia → infiltration of villi → atrophy/blunting.
  • Loss of mucosal integrity → increased intestinal permeability and consequently protein losing enteropathy leading to hypoproteinemia Hypoproteinemia in some cases and increased risk for sepsis.

Timecourse

  • Months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • D Thomas (1996)Manual of canine and feline gastroenterology.Eds: J W Simpson & E J Hall. BSAVA, Cheltenham.
  • Hall E J & Simpson K W (2000)diseases of the small intestine.In:Textbook of Veterinary Internal Medicine.S J Ettinger & E C Feldman (editors), W B Saunders. p1182.

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