Investigation of the Distribution of Ganglion Cells in the Appendix According to Location: A Cohort Study

Document Type : Original Article(s)

Authors

1 Associate Professor, Department of Anatomical and Clinical Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Resident of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Department of Obstetrics and Gynecology, Shahrekord University of Medical Sciences, Shahrekord, Iran

5 Anatomical and clinical Pathology, Mazandaran University of Medical Sciences, Mazandaran, Iran

6 Assistant professor of public health, Isfahan University of Medical sciences, Isfahan, Iran

Abstract

Background: Hirschsprung's disease (HD) is a congenital absence of ganglion cells. Due to the lack of consensus about the possibility of relying on the histology of the appendix to diagnose HD, appendectomy and sampling of the appendix are still performed in many centers in Iran and the world to diagnose it. This study aimed to evaluate the possibility of partial appendectomy and prevent total appendectomy to diagnose HD and determine the prevalence of aganglionosis in each part.
Methods: The present study was a prospective cohort study. The study population consisted of patients under 16 years of age in need of appendectomy who were referred to Isfahan teaching hospitals from March 2022 to March 2023. The inclusion criteria were age below 16 years and undergoing appendectomy with the diagnosis of appendicitis based on the Alvarado criteria, and the exclusion criteria were perforated or gangrene appendix and appendix neoplasia. The research variables included age and gender (as background variables) and the number of ganglion cells in each hpf (as dependent variable).
Findings: The average age of the examined patients was 8.84 ± 3.33 years. 58% of the patients were male. The total number of ganglion cells seen in the entire slide containing the samples was the highest in the middle and the lowest in the distal slides, which were significantly different (P = 0.038).
Conclusion: The middle part of the appendix has the highest number of ganglion cells and is the best part for biopsy for the HD diagnosis.

Highlights

Maryam Soltan: Google Scholar, PubMed

Mohammad Javad Yazdani: Google Scholar 

Keywords

Main Subjects

References

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Journal of Isfahan Medical School
Volume 42, Issue 767
3rd Week, July
July and August 2024
Pages 388-395

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History

  • Receive Date: 26 April 2024
  • Accept Date: 17 August 2024

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