A comparative histopathological evaluation of sacs from boys and girls with inguinal hernia.
The purpose of this study is to determine and to compare histopathologic alterations of hernia sacs obtained from patients with inguinal hernia with those of the peritoneal tissue from patients operated on for other abdominal disorders. Samples were obtained from 42 pediatric patients with uni- or bilateral hernias, and from 30 pediatric control patients without hernia. Sections were stained with hematoxylin-eosin, Gomori's trichrome, and Gomori's reticulin. Furthermore, they were immunohistochemically stained with anti-synaptophysin for the quantification of neural structures. All the slides were examined for six parameters, including variations in tissue and collagen types, the presence of inflammation and proliferation of vessels, neural plexus, and mesothelial cells. The results were evaluated statistically using the independent T-test and the Mann-Whitney-U test. Parametric tests revealed a higher presence of large neural plexus (p = 0.003), increased proliferation of mesothelial cells (p = 0.009), and hypervascularization (p = 0.003) in sacs of the hernia group. There were also major changes that were dependent on the sex of the patients. Most part of hernia sacs tissue was found to be fibrous and adipose in most boy patients, but was fibro-muscular in girls with inguinal hernia (male/female p = 0.03), while the tissues were fibro-adipose in both sexes in the control group (inguinal hernia/control p = 0.016). Similarly, vascular proliferation was mainly encountered in hernia sacs of girls (p = 0.013). These features were not observed in the control groups. Therefore, on the basis of sex, we determined whether or not these findings could indicate the difference between the etiopathologic mechanisms of inguinal hernias. Furthermore, we went into the question of whether or not the comprehensive examination of hernia sacs sufficed to enlighten the etiology of hernias.
Department of Pathology, Dr. Behçet Uz Children's Hospital, Kibris Sehitleri Cad. 51/11. 35220 Alsancak, Izmir, Turkey. ismetunlu@isnet.net.tr
Gülden
G
Diniz
Safiye
S
Aktaş
Ragip
R
Ortaç
Serafettin
S
Yegane
D000273:Adipose Tissue / Q000473:pathology; D000293:Adolescent; D001808:Blood Vessels / Q000473:pathology; D016022:Case-Control Studies; D002455:Cell Division; D002648:Child; D002675:Child, Preschool; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005355:Fibrosis; D006552:Hernia, Inguinal / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D009417:Nerve Tissue / Q000473:pathology; D010537:Peritoneum / Q000098:blood supply / Q000294:innervation / Q000473:pathology; D012727:Sex Characteristics