Pathological changes in the nerve ganglia of the colon in uncomplicated and complicated courses of diverticular disease; [Патологические изменения нервных ганглиев толстой кишки при различных вариантах течения дивертикулярной болезни]

Diverticular disease of the colon (DD), according to statistics from various countries, is one of the five most common diseases of the gastrointestinal tract throughout the world. It is known that 75% of diverticula carriers have asymptomatic disease. Up to 15% of cases life-threatening complications develop, leading to emergency surgery, and in the remaining 10% of patients the disease is continuously recurring. The question of finding predictors of the complicated course of DD is urgent for the healthcare system, for the timely identification of such patients, their optimal routing and treatment. Our study is devoted to assessing the characteristics of the nervous system of the colon wall in patients with complicated and uncomplicated diverticular disease in order to clarify the pathogenesis of DD and identify morphological predictors of a complicated course. Aim. Comparative analysis of clinical data and structural characteristics of the intermuscular nerve ganglia of the colon in patients with different course of DD and without colon diverticula to identify the morphological features of the complicated course of DD. Material and methods. A retrospective comparative analysis of clinical data, pathomorphological and ultrastructural changes in the intermuscular nerve ganglia in surgical material from 68 patients who underwent left hemicolectomy was carried out. Results. We comprehensively analyzed 68 clinical cases of patients who underwent left hemicolectomy for complicated DD (37), uncomplicated DD (19) and observation without colon diverticula (12). It was revealed that in men this disease occurs at a younger age than in women [Me age of men – 49 (39.5; 61) years, women – 66.5 (58; 81); U=178, p<0.001]. It was shown that the glial index in cases with DD is 1.25 times higher than in the comparison group (cases without colon diverticula) (p<0.05). Conclusion. The study demonstrates the age and gender characteristics of DD, as well as significant differences in the values of the glial index in the groups of patients with DD and without colon diverticula, which shows the significance of nervous system pathology in the development of DD of various course variants. © 2024 Geotar Media Publishing Group. All rights reserved.