Abstract
Background: Appendicectomy is most commonly performed intra-abdominal surgery. The exact etiopathogenesis of appendicitis is not exactly understood. Though eosinophils and ganglion cells are been observed routinely in appendix by many pathologists, little is being highlighted in literature in this regard. Present study was done to access the significance of mean cell count and topography of ganglion cells and eosinophils in association with histological type of appendicitis. Methods: It’s a retrospective study which included 93 appendicectomy specimens, out of which 65 were included. Remaining 28 cases with gangrenous change, perforation and neoplastic lesions were excluded. Mean cell count of eosinophils and ganglion cells was calculated. Topographical distribution and mean cell count of eosinophils and ganglion cells were correlated with histopathological type of appendicitis. The significance of association was calculated by chi-square test. Result: The mean eosinophil count was significantly higher in acute appendicitis compared to recurrent appendicitis with a p-value of <0.001. The ganglion cells were found to be more in acute appendicitis than recurrent appendicitis and was statistically significant (p=0.007). Topographic distribution of ganglion cells was predominantly noted within the circular layer only and between longitudinal and circular muscle layer along with circular layer of the muscularis propria in both acute and recurrent appendicitis. Conclusion: Mean count of eosinophils and ganglion cells were significantly increased in acute appendicitis. Hence, it may be considered as additional diagnostic criteria for acute appendicitis. Atypical localization of ganglion cells in circular layer was noted in both acute and recurrent appendicitis.
Highlights
Appendicectomy is one of the most commonly performed intra-abdominal surgery.[1]
Mean count of eosinophils and ganglion cells were significantly increased in acute appendicitis
It may be considered as additional diagnostic criteria for acute appendicitis
Summary
Appendicectomy is one of the most commonly performed intra-abdominal surgery.[1]. There is a chance of 6-20 % of general population experiencing appendicitis during their lifetime out of which only 1 in every 6 people undergo appendicectomy. [2] The exact function of normal appendix and the etiopathogenesis of appendicitis is not completely understood. [2] The exact function of normal appendix and the etiopathogenesis of appendicitis is not completely understood. IgE released is thought to produce abundant swelling which further compromises the blood supply and leads to mucosal damage. The mast cells play central role in type I hypersensitivity reaction. The eosinophils reach the site as a sequel of mediators released from mast cells such as eosinophilic chemotactic factors. Such response occur in other segments of intestine, but in contrary to the rest of the bowel, appendix is commonly involved because of its size and poor capacity to harbour edema fluid without much compromise in the blood supply to mucosa. Present study was done to access the significance of mean cell count and topography of ganglion cells and eosinophils in association with histological type of appendicitis
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