Background/purpose: Presence of ganglion cells in the appendix excludes total colonic aganglionosis. However, it remains unclear whether or not absence of ganglion cells in this organ should be a criterion to rule in the disease. The aim of this study was to examine for presence and number of myenteric ganglion cells in vermiform appendix taken from various surgical conditions and controls.
Material and Methods: One hundred and thirty two appendectomy specimens were available for the study; group I, total colonic aganglionosis (TCA); group II, other type of Hirschsprung's disease (HSD); group III (control), incidental appendectomy in cases without aganglionosis; group IV, acute appendicitis. Amount of ganglion cells was evaluated semiquantitatively in blinded fashion.
Result: The number of ganglion cells in any given high power field (HPF) was very variable in all groups; group I no ganglion cells found, group II 1.03 (0-2.9), group III 0.67 (0-2.4), group IV 0.46 (0-1.8) cells/HPF. There was significant difference between the HSD group and groups with TCA or appendicitis. Absence of ganglion cells in the appendix could be detected in 100%, 16.7%, 13.1% and 27.3% in groups I, II, III and IV, respectively.
Conclusion: Aganglionosis of the vermiform appendix could not provide a diagnostic clue to total colonic aganglionosis because the condition could be found in other conditions.