急性虫垂炎における非特異的血管炎について

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概要

• 論文の詳細を見る

• Recently, many diseases producting vasculitis such as Periarteritis nodosa etc, have been noticed. However, even now, the study on the vascular changes involved in the nonspecific inflammation is insufficient. A study on the vascular changes was undertaken by using acute appendicitis as a non-specific inflammation.<BR><I>Material and method</I>: One hundred and seventy eight appendix vermiformises were sellected as “Acute appendicitis (Aschoff) ” out of 431 cases resected under “Acute appendicitis clinically”. The “Acute appendicitis (Aschoff) ” should represent a “Field” of a typical non-specific inflammation, followed by Aschoff's Staging, namely Stage-I: Small phlegmonous foci in crypts, II: Appendicitis phlegmonosa ulcerosa (within the 1st clinical day), III: Appendicitis ulcerosa gravis et phlegmonosa gravis (2nd day), IV: Appendicitis gangrenosa et perforativa ( 3rd day) and V: Appendicitis cicatricans (after 4th day) . Arteries involved in the “Acute appendicitis (Aschoff) ” were studied histopathologically.<BR><I>Result</I>: Arteries first show peri- and endoarteritis, then the inflammation extends in media from adventitia mainly, inducing hydropic and dissociating change. Neutrophilic granulocytes migrate into media showing panarterial inflammation at Stage-III on the 1st to 2nd clinical day. Then, if the inflammation would continued marked for a certain duration, a strain will occur in the arterial wall and some of arteries become expand. In some cases, if the expansion would continue, the structure of arterial wall will be destructed and aneurysm occurs on the 3rd clinical day. The aneurysmal arteries show soon intimal thickening or thrombosis to keep the luminal size in normal within a week.<BR><I>Conclusion</I>: Those changes of arteries observed in the “Acute appendicitis (Aschoff ), ” a kind of arteritis based upon the non-specific inflammation, should be concluded as a non-specific arteritis, considered reasonably applied in general.

• 学校法人 昭和大学・昭和医学会の論文

著者

• 増田 弘毅

  昭和大学医学部第一病理学教室

• 工村 房二

  昭和大学医学部第一病理学教室

• 塩川 健

  昭和大学医学部第一病理学教室

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