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© КОЛЛЕКТИВ АВТОРОВ, 2016 UDC 612.363:616.381.5
A. Che§ca 1, A. Ciomeica 1, T. Sandle2
STRUCTURAL ASPECTS ON PATHOLOGIC APPENDIX VERSUS NORMAL APPENDIX
1Faculty of Medicine, Transilvania University of Bra§ov (Romania), 2University of Manchester (United Kingdom)
Appendix pathology brings together different forms and is found in different age segments. Most susceptible to disease are children. In this context, the children and young people Appendix pathology may be complicated or can be accompanied by damage to adjacent organs, located in the abdominal cavity.
This morphological study presents the structural aspects of normal appendix and the ulcerated appendicitis. For observation of structural aspects, has been used classic stainings. It also shows the appendix using immunohistochemi-cal technique.
Key words: appendix, appendicitis, structure, analysis
Appendix pathology is common in young children but being frequently exposed to the risk of this condition. According to studies it was observed installing a flare according to the seasonal period [2, 18]. In this context, nutrition and stress, configuring individual's lifestyle matters in the occurrence of acute appendicitis [3, 7]. Also demographic factor and genetic profile of the individual are factors which contribute to this pathology installation. With the first signs and symptoms that advocates for acute appendicitis, the patient must be addressing any medical specialty services [19, 22]. Interdisciplinar medical emergency team, aims to involve for a proper diagnostic [1, 11]. The method of laboratory diagnostics together with imaging methods such as ultrasound or computed tomography, are useful for a well diagnostic [4, 12].
Of course imaging methods aimed at informing the diagnostic accuracy of acute appendicitis, avoiding a false diagnosis [5, 8]. From this point of view, will track the removal of other signs and symptoms that may mimic appendicitis [15]. It is envisaged and competent examination of the abdominal region where they are routinely positioned appendix, to identified correct position of the appendix [14]. In the particular context of appendix positioning know, besides the right iliac fossa [17].It also is considering removing elimination of acute appendiceal pathology connected with acute gynecologic pathology, especially the young [20]. According to data taken from medical literature, they were recorded cases of appendicitis in young women's, who required emergency appendectomy practice [6, 10]. For diagnosis, corroborating signs and symptoms of clinical laboratory data, leading to practice curative surgery [9, 16].
Macroscopic examination of the operatory piece, followed by microscopic analysis, confirm the
type of acute appendicitis, ulcers, or gangrenouse phlegmon, with possible confounding local complications that could affect the patient's life [21].
From this point of view, preventive measures, informative programs with educational purposes, may interfere with the lifestyle of patients and to delay the time to occurrence of an exacerbation of acute appendicitis [13]. In context, the management of this condition is important both preoperatively and postoperatively as well.
MATERIALS AND METHODS
To achieve this material was chased surgical clinical diagnosis. It is composed of combination of acute appendicitis and colitis bracket peritoneal hemorrhagic necrosis. For the study was used as a biological product, appendix and fragment bracket. From a macroscopic viewpoint, was observed operative piece, which is represented by 50 mm long appendix, purple, accompanied by a second fragment sent. Histopathological diagnosis established after analyzing of excised intraoperatively piece, refer to appendix with bleeding ulcers mucosal edema and stasis subse-ries, accompanied by peritoneal reshuffle fibro-conjuctiva fragment, infiltate and hemorrhagic necrosis.
RESULTS AND DISCUSSIONS
In the following, they will describe some structural features related to normal and pathological appendix. Histologically, in appendix shows the outside and serous epithelial lining is made and corium. Type of epithelium is simple cylindrical, cells occurring absorbent and fewer goblet cells. Corion shows Lieberkuhn glands and lymphoid tissue. The structural elements of the appendix show some particularities, according to the form of appendicitis. Figure 1 shows the structural aspect of normal appendix. The section from Figure 1 is the typical appearance of mu-
Figure 1 - Normal Appendix. H&E staining
Figure 3 - Normal Appendix IHC
cous layer. Also we can see appendix muscle part with two continuous layers, internal circular and external longitudinal. Formations observed in muscle venous vascular type, thin walled, of different sizes, containing inside blood type structures (fig. 1). Figure 2 shows in detail, the lining of the appendix. On this picture is seen besides those mentioned above, the structural aspect of goblet cells (fig. 2). Figure 3 performedby im-munohistochemical technique, show specific structural elements of appendix. On this image can be seen characteristics lymphoid follicle, willing as a crown and extending into the submuco-sa, so muscle lining it is not observed (fig. 3). In the following we will present some pictures showing specific structural aspects of ulcerated appen-
Figure 2 - Normal Appendix. H&E staining
Figure 4 - Ulcerate Appendix. H&E staining
dicitis. Figure 4 shows the specific issue of lymphoid follicles, ulcerated mucosa and muscle of appendix (fig. 4).
Figure 5 shows in detail the structural aspect reffering to mocosa of ulcerated appendicitis. On this section, there are no important differences compared to conventional structural aspect of the appendix (fig. 5). Figure 6 shows in detail the appearance of lymphoid follicle, the muscle with two layers specific muscle and blood vessels of venous type. Described refers to specific appendix for ulcerated appendicitis. (fig. 6).
CONCLUSSIONS In any form of appendicitis is required after surgical excision histological analysis of the oper-atory piece.
Figure 5 - Ulcerate Appendix. H&E staining
Any microscopic analysis is preceded by microscopic analysis of the operatory piece.
For structural analysis is useful comparison with histological structural issues. Also immuno-histochemical technique successfully complete morphological analysis of the appendix, either normal or pathological.
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Received 05.07.2016
А. Ческа, А. Киомейка1, Т Сэндл2
СТРУКТУРНЫЕ АСПЕКТЫ ИЗУЧЕНИЯ ПАТОЛОГИЧЕСКОГО И НОРМАЛЬНОГО АППЕНДИКСА 1 Факультет медицины университета Трансильвании Брашов (Румыния), 2Университет Манчестера (Великобритания)
Патология аппендикса объединяет различные формы и встречается в различных возрастных сегментах. Наиболее восприимчивы к заболеванию дети. В этом контексте у детей и лиц молодого возраста патология аппендикса может быть сложной или может сопровождаться повреждением соседних органов, расположенных в брюшной полости.
Это морфологическое исследование представляет структурные аспекты нормального и патологического аппендикса. Для наблюдения структурных аспектов применялось классическое окрашивание, а также использовалось иммуногистохимическое исследование.
Ключевые слова: аппендикс, аппендицит, структура, анализ
А. Ческа1, А. Киомейка1, Т Сэндл2
ПАТОЛОГИЯЛЫКЖЭНЕКАЛЫПТЫАППЕНДИКСТЗЕРДЕПЕУДЩК^РЫЛЫМДЫК КЫРЛАРЫ Трансильвания Брашов (Румыния) университеты^ медицина факультет, 2Манчестер университет/' (¥лыбритания)
Аппендикс патологиясы эртYрлi формаларды б1р1кт1ред1 жэне эртYрлi жастар топтарында кездесед1. Бул ауруFа балалар барынша бей1м келед1. Бул туррыда балалар мен жасесп1р1мдерде аппендикс патологиясы ^рдел1 болуы немесе ш куысындаFы керштес орналаскан органдардын закымдалуымен ету1 мYмкiн.
Бул морфологиялык зерттеу калыпты жэне патологиялык аппендикстН курылымдык кырларын керсетедк Курылымдык кырларды бакылау Yшiн классикалык бояу колданылды, сол сиякты иммуногистохимиялык зерттеу пайдаланылды.
Клт сездер: аппендикс, сокыршек, курылымы, анализ
