RESUMEN
Purpose@#Biliary atresia (BA) is a disease that manifests as jaundice after birth and leads to progressive destruction of the ductal system in the liver. The aim of this study was to investigate histopathological changes and immunohistochemically examine the expression of glial cell line-derived neurotrophic factor (GDNF), synaptophysin, and S-100 protein in the gallbladder of BA patients. @*Methods@#The study included a BA group of 29 patients and a control group of 41 children with cholecystectomy. Gallbladder tissue removed during surgery was obtained and examined immunohistochemically and histopathologically. Tissue samples of both groups were immunohistochemically assessed in terms of GDNF, S-100 protein, and synaptophysin expression. Expression was classified as present or absent. Inflammatory activity assessment with hematoxylin and eosin staining and fibrosis assessment with Masson's trichrome staining were performed for tissue sample sections of both groups. @*Results@#Ganglion cells were not present in gallbladder tissue samples of the BA group.Immunohistochemically, GDNF, synaptophysin, and S-100 expression was not detected in the BA group. Histopathological examination revealed more frequent fibrosis and slightly higher inflammatory activity in the BA than in the control group. @*Conclusion@#We speculate that GDNF expression will no longer continue in this region, when the damage caused by inflammation of the extrahepatic bile ducts reaches a critical threshold. The study's findings may represent a missing link in the chain of events forming the etiology of BA and may be helpful in its diagnosis.
RESUMEN
Purpose@#Biliary atresia (BA) is a disease that manifests as jaundice after birth and leads to progressive destruction of the ductal system in the liver. The aim of this study was to investigate histopathological changes and immunohistochemically examine the expression of glial cell line-derived neurotrophic factor (GDNF), synaptophysin, and S-100 protein in the gallbladder of BA patients. @*Methods@#The study included a BA group of 29 patients and a control group of 41 children with cholecystectomy. Gallbladder tissue removed during surgery was obtained and examined immunohistochemically and histopathologically. Tissue samples of both groups were immunohistochemically assessed in terms of GDNF, S-100 protein, and synaptophysin expression. Expression was classified as present or absent. Inflammatory activity assessment with hematoxylin and eosin staining and fibrosis assessment with Masson's trichrome staining were performed for tissue sample sections of both groups. @*Results@#Ganglion cells were not present in gallbladder tissue samples of the BA group.Immunohistochemically, GDNF, synaptophysin, and S-100 expression was not detected in the BA group. Histopathological examination revealed more frequent fibrosis and slightly higher inflammatory activity in the BA than in the control group. @*Conclusion@#We speculate that GDNF expression will no longer continue in this region, when the damage caused by inflammation of the extrahepatic bile ducts reaches a critical threshold. The study's findings may represent a missing link in the chain of events forming the etiology of BA and may be helpful in its diagnosis.
RESUMEN
Abdominal pain is a frequently encountered problem in children. Suspicious right lower quadrant pains are sometimes a problem for pediatric surgeons. In this study, we wanted to evaluate the effectiveness of laparoscopy in diagnosis and treatment of children with suspicion of abdominal pain. The files of 84 patients treated with a diagnosis of suspicious right lower quadrant peritonitis between 2005 and 2011 were investigated. Laparoscopic exploration was performed for all cases with right lower quadrant pain where the appendix was not seen on USG/CT and the cause of acute abdomen could not be determined. In this process, 84 patients consisting of 60 [71%] females and 24 [29%] males were included in the study. The mean age was 10.5 years [7-16 years]. Appendicitis was determined during diagnostic laparoscopy in 35 [41.6%] patients. The appendix was normal in the remaining 49 [58.3%] patients. In 36 of these patients, gynecological diseases were encountered on pathology as the most frequent cause of the acute abdomen. The appendix was preserved in patients where the cause of the abdominal pain was explained. Laparoscopy can be used in the diagnosis and treatment of patients with suspected acute abdomen that imitates acute appendicitis and cannot be differentiated with physical examination and laboratory methods. Delays in diagnosis and unnecessary appendectomy will be prevented in this way