PATHOLOGICAL DISORDERS OF THE STRUCTURE OF THE DIAPHRAGM OF RATS UNDER THE INFLUENCE OF MECHANICAL JAUNDICE AND PNEUMOPERITONEUM

Abstract

Despite the advantages, laparoscopic surgery and carbon dioxide affect many organs and systems of the body, such as the brain, lungs, kidneys and liver. In the presence of pneumoperitoneum, during laparoscopic surgery, the diaphragm is displaced caudal by 2–3 cm, thereby reducing lung volume. The aim of the work was to investigate the histological features of changes in the costal part of the diaphragm of rats with simulated obstructive jaundice and the effect of intra- abdominal pressure of 5 mmHg, created by carbon dioxide insufflation, similar to pneumoperitoneum during laparoscopy.We divided 80 healthy sexually mature rats, 6 months old, into 6 experimental groups. Obstructive jaundice was simulated under anesthesia by creating a laparotomic access through which the pyloric part of the stomach and duodenum were removed, after which the common bile duct and pancreatic duct were visualized and the common bile duct was ligated.Pneumoperitoneum was formed by insufflation of carbon dioxide using the KARL STORZ electronic laparoflator 264300 20 insufflator. Histological material was stained with hematoxylin and eosin. The results obtained showed that under the influence of bilirubin intoxication, circulatory disorders were detected in the microcirculatory system and medium-sized vessels. Morphological signs of endothelial dysfunction were observed. Small lymphocytic infiltrates were also detected in the endomysium and perimysium. On longitudinal sections, transverse striation was often weakly expressed or not visualized. There were foci of sarcoplasmic decay and fragmentation of the fibers themselves. Under the influence of intra-abdominal pressure, a deterioration of the morphological picture was noted. The intermuscular spaces were distinguished by increased cellular infiltration. On longitudinal sections, fibers of different diameters, myofibrils are unevenly stained and defibered, transverse striation is also uneven and weakly expressed. In summary, based on the obtained histological data, it was stated that mechanical jaundice leads to structural reorganization of the diaphragm and the injury caused by pneumoperitoneum depends on the duration of intra-abdominal pressure.