Morphological and morphometric characteristics of the subcompensated dolichocolon

Abstract

Chronic constipation is one of the most urgent problems in modern coloproctology and is observed in 14–16% of the population of developed countries. The causes of chronic constipation vary widely from functional to organic. The latter include various variants of dolichocolon, which occur in 16% of cases.The aim of the study was is to give a morphological and quantitative characteristic of subcompensated dolichocolon based on the morphogenesis of changes, compared with histologically normal colon.Material and methods. Colon tissue samples from 15 people were used, which were divided into two groups. The first, control group consisted of 5 sectional cases of a morphologically normal colon wall. The second group was represented by the surgical material of 10 patients with subcompensated dolichocolon. Observation groups were representative by sex and age.Results. In patients with subcompensated dolichocolon, compared with the control group, the thickness of the mucosa in the colon wall is statistically significantly (p=0.034) reduced by 1.06 times, which indicates atrophy; the thickness of the submucosal layer increases by 1.55 times due to edema with foci of sclerosis (p=0.0001); the thickness of the muscle layer increases by 1.16 times (p=0,0003), because of working hypertrophy and compensatory hyperplasia of smooth muscle cells; at the same time, the number of nerve cells in Auerbach's plexuses decreases by 1.59 times (p=0,0001), which will lead to atrophy of the muscle layer and decrease its evacuator-motor function; the average area of lymphoid follicles increases by 1.35 times (p=0,003) and the percentage of secondary follicles decreases 8 times (p=0,0001), which is a consequence of congestion of intestinal contents and activation of the intestinal lymphoid apparatus.Conclusion. Morphological signs of atrophy and sclerosis changes of the cellular elements of the colon neuromuscular apparatus begin to form at the subcompensated stage of dolichocolon, which requires new objective clinical and morphological indications for surgical treatment of patients in order to prevent the development of decompensation of the patients’ general condition and severe complications.

Appendicitis mimicry of dolichocolon

“…There are no published criteria for cellular confirmational diagnosis of dolichocolon. However, recent data supports cellular evidence of late-stage dolichocolon described as morphologic atrophy and sclerosis of the colonic neuromuscular-apparatus [ 1 ]. There are no standard algorithms for dolichocolon management at this time.…”

“…Approximately 14%–16% of the population in developed countries struggle with chronic constipation, with symptoms to include nonspecific, generalized symptoms including abdominal pain, weight fluctuation, and indigestion [ 1 ]. Furthermore, the etiology of chronic constipation is even vaster than its nonspecific symptoms, one being dolichocolon, with an incidence rate of 1.9%–28.5% [ 1 , 2 ].…”