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Year 2015 Vol. 23 No 2
GENERAL AND SPECIAL SURGERY
I.A. KRIVORUCHKO, I.A. TARABAN, I.V. SOROKINA, N.N. GONCHAROVA
MORPHOLOGICAL FEATURES OF CAVITARY FORMATIONS IN ACUTE PANCREATITIS
Kharkov National Medical University of the MH of Ukraine
Objectives. To study the features of the morphological structure of the wall of cavitary formations in acute destructive pancreatitis at different stages of development using immunohistochemical methods.
Methods. The features of the wall microstructure of cavitary formations and adjacent pancreatic parenchyma have been studied on the biopsied material (81 cases) depending on the morphology of the connective tissue component using histological, histochemical and immunohistochemical methods.
Results. It was established that in patients both as with complicated and not complicated delimited pancreatic necrosis foci at the morphological study a similar pattern has been observed. The wall of formation and glandular interstice were presented by a loose fibrous connective tissue with primary predominance of cellular elements and small volume of fibers, thus both focal (non-complicated course), and diffuse (complicated one) inflammatory infiltration of the formation wall was registered. The presence of dense connective tissue, the localization of the inflammatory infiltrate in the inner layers of the wall, prevalence of type I collagen in the capsule of pseudocysts as well as cells producing IL-2 and IL-6 testified to the reduction of the inflammatory process activity. Loose connective tissue, diffuse inflammatory infiltration in all layers of the wall, the predominance of type III collagen and reduction of the number of cells producing IL-2 and IL-6 manifested the inflammatory activity retention. Taking into account the commonality of morphological changes in patients with complicated pseudocysts and delimited foci of pancreatic necrosis, all forms of cavitary formations were considered as initially unfavorable course of the pathological process, requiring surgical correction.
Conclusion. Growth factors and cytokines are thought to be the triggers of the pancreatic fibrogenesis. IL-2 and IL-6 promote the intracellular matrix synthesis rich of collagen type I and III, thus promoting fibrosis in pancreatitis. It was established that in pancreatitis not only the content synthesis of the extracellular matrix is increased, but also its degradation is inhibited by reducing the specific activity of metalloenzymes.
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61022, Harkov, Ukraina, pr. Lenina, d. 4,
Harkovskiy natsionalnyiy meditsinskiy universitet,
kafedra khirurgii 2,
tel. office 38 050 301-90-90,
Taraban Igor Anatolevich
Krivoruchko I.A. MD, professor, a head of the surgery chair ¹2 of Kharkov National Medical University.
Taraban I.A. MD, professor of the surgery chair ¹1 of Kharkov National Medical University.
Sorokina I.V. MD, professor of the pathologic anatomy chair of Kharkov National Medical University.
Goncharova N.N. PhD, doctoral candidate of the surgery chair ¹2 of Kharkov National Medical University.