Document Detail


New pathogenetic aspects of gut dysmotility in aplastic and hypoplastic desmosis of early childhood.
MedLine Citation:
PMID:  11315273     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The peristaltic movement of the gut is a function of the alternating contraction and relaxation of circular and longitudinal muscles. This movement is induced by a tendon-like connective-tissue net (TCTN) in the circular and longitudinal muscles, which are both rooted in a connective-tissue plexus layer (CTPL). In children with a therapy-resistant aperistaltic or hypoperistaltic syndrome who had normally-developed enteric innervation, a lack of the TCTN in the muscularis propria was observed. Over the last 2 years, 241 children with chronic constipation were investigated histopathologically; 46 children surgically treated by partial resection of the gut or diagnostically investigated by whole-mount biopsy. Fifteen children had a hypoperistalsis syndrome and 3 had an aperistalsis syndrome. All specimens were native and cut in a cryostat. Enteric innervation was examined by acetylcholinesterase and dehydrogenase reactions. The TCTN in the muscularis propria was stained with picric acid/sirius red. In the children with an aperistalsis syndrome, a complete lack of the TCTN in circular and longitudinal muscles was observed. A CTPL was not developed. The children with a hypoperistalsis syndrome had no CTPL, but had a partly-developed TCTN in the circular and longitudinal muscles, which gradually faded in the direction of the plexus layer. Independent of a well-developed enteric nervous system, a lack of the TCTN in longitudinal and circular muscles and a missing CTPL (aplastic desmosis) abolishes the coordinated peristaltic movement of the gut. An isolated lack of the CTPL in the myenteric plexus (hypoplastic desmosis) results in a hypoperistalsis syndrome. An anomaly of the TCTN in the muscularis propria disturbs gut-muscle mechanics, and is another cause of gut dysmotility.
Authors:
W A Meier-Ruge; A M Holschneider; A F Schärli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric surgery international     Volume:  17     ISSN:  0179-0358     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-04-23     Completed Date:  2001-08-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  140-3     Citation Subset:  IM    
Affiliation:
Institut für Pathologie, Universität Basel, Schönbeinstrasse 40, 4003 Basel, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Chronic Disease
Connective Tissue / pathology
Constipation / pathology,  surgery
Desmosomes / pathology*
Diagnosis, Differential
Enteric Nervous System / pathology
Female
Gastrointestinal Motility / physiology*
Hirschsprung Disease / pathology,  surgery
Humans
Intestinal Diseases / pathology*,  surgery
Intestinal Pseudo-Obstruction / pathology,  surgery
Male
Muscle, Smooth / pathology
Peristalsis / physiology*

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