Studies on the Probable Role of Immune Mechanism in Pathogenesis of GaD Bladder Diseases

Abstract

Inspite of technical advances like ultrasonography and ERCP in investigating cholecystitis and gallstones, the underlying primary event that starts pathology is not definite. Many theories tried to explore the pathogenesis but no unitarian theory could explain all cases. Infection theory was postulated in cholecystitis and in uncomplicated gallstones (Yio eta/., 1992). Cholesterol nucleation (Gallinger et a/., 1987), mucin nucleation (smith & La Mont, 1986.), altered bile composition (Carey & Small, 1978) and gallbladder dysfunction (Bolondi et al, 1985) were all postulated, beside others, to throw some light on pathogenesis of cholecystitis and gallstone fonnation.

Till now there is very little references, if any, in standard textbooks considering the immunopathological event as a start point in pathogenesis of cholecystitis and gallstone formation.

The aim of this thesis is to find out the possibility of immunological role in the pathogenesis of cholecystitis.

This thesis includes 60 patients (30 chronic calcular and 30 chronic non calcular cholecystitis) of different sex and age. All patients were subjected to complete medical history, clinical examination, CBC, ESR and abdominal ultrasonography. Serum lgA, bile lgA & immune complexes were measured by radial immunodiffusion technique. The surgically removed gallbladder tissues were examined histopathologically to be sure of chronic