Imaging of the intestinal microcirculation

Microcirculatory dysfunction is important in different intestinal pathologies. Therefore, it is essential for adequate therapeutic strategies to be based on reliable microcirculatory diagnostics. Intestinal microvascular perfusion is regulated by an intricate interplay of neuroendocrine, paracrine and mechano-sensory pathways. While rectal microvascular bed can be readily examined at the patient's bedside, microcirculation of other parts of the gut can only be assessed intra-operatively or by means of enterostomies. Changes in intestinal microcirculation in various diseases, as observed in animal experiments, further contribute to our understanding of intestinal microcirculation in humans. If microcirculatory changes are not adequately taken care of, perfusion will be reduced and tissue oxygenation may be endangered. Relevant clinical studies are presented in this article. Future developments, e. g. miniaturization of optical probes or swallow-able cameras, will facilitate sophisticated diagnostics and thus improve treatment results.