Introduction. Patients suffering from obstructive jaundice (OJ) represent a particularly challenging cohort.
The objective of the study was to examine the morphological features of the right and left cruses of diaphragm under conditions of obstructive jaundice and exposure to pneumoperitoneum (PP).
Materials and methods. The present study was conducted on a total of 75 rats, with an average age of six months, who were divided into five distinct groups. The animals were employed as a model for obstructive jaundice and pneumoperitoneum.
Results. Structural changes because of bilirubin intoxication were detected, such as oedema, dystrophic and degenerative lesions of the muscle fibers (MFs), and the presence of cellular infiltrates. The additional “high pressure” PP resulted in greater destruction, and after one hour, foci of cytolysis were observed. In the adjacent MFs, myofibril disintegration was present, and in other areas, variants of dystrophic changes were observed. The heterogeneity of fibres was clearly visualised in transverse sections, revealing the presence of hypertrophied MFs alongside rounded atrophic MFs. Within a 2-hour time frame, the nuclei underwent hyperplasia, a rare occurrence. Significant oedema manifested proximally to the vessels, arterioles and small veins, which exhibited weak blood filling. The endothelium underwent exfoliation. In a later stage, along with previous changes, there were cellular debris, necrotic changes, loss of internal optical contrast, characteristic pattern and indistinct borders.
Conclusions. The results obtained demonstrate that OJ alone and in combination with PP causes morphological and structural changes in the diaphragmal cruses.
Keywords: diaphragm, jaundice, morphology, laparoscopy, intra-abdominal pressure.
Full text sources https://doi.org/10.31688/ABMU.2025.60.1.06
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Address for correspondence:
Myroslav Yu. KRITSAK
Horbachevsky Ternopil National Medical University
Address: Maidan Voli 1, 46001 Ternopil, Ukraine
E-mail: kricakmy@tdmu.edu.ua
