It is recognized the leading role of H. Pylori in the aetiology and pathogenesis of diseases of the gastrointestinal tract, it is established morphological features of changes in the mucosa at mono-infection. However, lesions of the stomach may have mixed infectious character, changing the course of the main disease. The aim of the research is to investigate the statement of the mucous membrane in its contamination with H. Pylori, Fungi of the species Candida, cryptosporidium in patients with irritable bowel syndrome. Biopsies of the mucous membrane of different stomach parts were studied, using conventional methods of dyeing with further evaluation of the results. Pathological changes in the stomach mucosa were depended on the localization of the process, the measure of contamination, and the presence of various life forms of pyloric Helicobacter whereas cryptosporidium and fungi of the species Candida (non-invasive form) did not influence essentially.
The aim of the study was to study the morphological features of the inflammatory processes of the mucous membrane of various parts of the stomach and duodenum in patients with chronic gastritis and duodenitis. 24 patients (18 men and 6 women) were observed with chronic gastritis and duodenitis associated with Helicobacter pylori. The average age of the patients was 47 years. 120 biopsy samples of the mucosa of different parts of the stomach and duodenum were studied using histological, histochemical, morphometric and microbiological methods. Histological and microbiological examination of biopsy specimens revealed chronic antral gastritis, chronic fundal gastritis and chronic diffuse pangastritis. Superficial chronic duodenitis was rare and was erosive only in 11.4%. Helicobacter pylori in biopsy of stomach samples were detected more often in associations of various forms. Chronic antral gastritis of the type B was characterized by a predominantly high activity of the pathological process, moderate atrophy of the pyloric glands and a high incidence of small bowel metaplasia. Violations of the microvasculature, hemorrhages in the interfoveolaris part, plethora of blood vessels, and sludge in the capillaries were revealed in the lamina propria of the mucosa of the antrum of the stomach; lymph nodes with pronounced germinal centers were observed in half the cases. In the interfoveolaris part of the lamina propria of the mucous membrane, a high density of inflammatory cell infiltrate was observed, in which plasmocytes, lymphocytes, fibroblasts, fibrocytes, eosinophilic and neutrophilic granulocytes, macrophages were detected. Chronic fundal gastritis of the type B was characterized mainly with moderate and minimal activity of the pathological process. Helicobacter pylori were detected on the surface of the entire epithelium. Focal small intestinal metaplasia and atrophy of the main glands were rarely detected. Atrophy of the main glands was predominantly and minimal and was often combined with hyperplasia of parietal cells. The density of the inflammatory cellular infiltrate remained high; plasmocytes, lymphocytes, fibroblasts, eosinophilic and neutrophilic granulocytes, macrophages were found in it (in decreasing order). The study of biopsy samples of the mucosa of different parts of the stomach and duodenum against the background of contamination with a pyloric helicobacter revealed the presence of chronic antral, fundal gastritis and chronic duodenitis of the II-III degree with the development of small bowel metaplasia and dysplasia.
The actuality of the problem is associated with an increase in the number of patients with cholelithiasis of working age and a significant increase in cholecystectomies not only in Russia, but throughout the world. It is known that more than 2,5 million are performed annually. Moreover, 5-40% of operated patients develop postcholecystectomy syndrome, which is manifested by recurrent abdominal pain and cholegenic diarrhea. The aim of the study is to assess morphofunctional changes in the mucous membrane of various parts of the intestine in patients with postcholecystectomy syndrome. Histological, histochemical, morphometric and bacterioscopic, parasitological methods were used to study 42 biopsy specimens of the mucous membrane of various parts of the intestines of patients who underwent cholecystectomy. The control group consisted of 18 biopsies of practically healthy individuals. To objectify the study, a morphometric study of the mucous membrane of the duodenum according to 34 parameters, of the cecum and sigmoid colon according to 22 parameters was carried out. In the mucous membrane of the duodenum, chronic duodenitis of varying degrees of activity of the pathological process and atrophy of the intestinal villi were revealed, the intestinal glands were shortened, the intestinal villi are less wide. The epithelial layer of intestinal villi and intestinal glands was abundantly infiltrated with neutrophilic granulocytes. The density of the inflammatory cellular infiltrate in the stroma of the intestinal villi and intestinal glands increased. On the surface of the epithelial layer of the intestinal villi and between the intestinal glands, campylobacters were often found, less often - cryptosporidia. In the mucous membrane of the cecum and sigmoid colon, chronic colitis of varying degrees of activity of the pathological process and atrophy of the intestinal glands were revealed. The thickness of the mucous membrane and the depth of the intestinal glands were lower than normal. Thus, in patients with postcholecystectomy syndrome, pronounced morphometric and histological changes were revealed in the mucous membrane of various parts of the intestine, while the depth and degree of its damage were more significant in its proximal parts.
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