Determination of membrane tension during balloon distension of intestine.

Abstract

During the last decades, it has become increasingly common to make balloons distension in visceral organs in vivo. In particular this is true for studies of gastrointestinal motor function and biomechanics. Balloon distension is often used for assessment of small intestinal compliance and tension based on Laplace's law for cylindrical pressure pipes. This commonly used law is valid only when the balloon-distended intestine is cylindrical. Experimentally, it is seen that the diameter of the balloon-distended intestine is not a constant, but variable in the axial direction. Hence, it is necessary to improve Laplace's law for intestinal investigation. In this paper we develop the framework for determination of the tension distribution in circumferential and longitudinal direction during balloon distension. When the radii of curvature are measured from a photograph of the intestinal profile, then the membrane stress resultants can be computed everywhere in the intestine in contact with the balloon from the equations of equilibrium. The experimental data were obtained from small intestinal segments from five pigs and three guinea pigs. Papaverine was injected before the animals were sacrificed to relax the intestinal smooth muscle. The segments were immersed in a bath with calcium-free Krebs solution with dextran and EGTA. A balloon was distended in the lumen with pressures up to 15 cmH2O in the pigs and 10 cmH2O in the guinea pigs and radii were measured along the z-axis. The tension in circumferential direction had its maximum approximately 25% away from the middle of the balloon. The circumferential tension was 2-3 times higher than the longitudinal tension. In conclusion when we know the shape of the intestine, we can compute the circumferential and longitudinal components of tension. The large variation in tensions along the z axis must be considered when performing balloon distension studies in the gastrointestinal tract for studying physiological and pathophysiological problems in which loading conditions are important, e.g. intestinal mechanoreceptor studies in order to obtain accurate description of the biomechanics and the stimulus-response function.