Inflammatory changes secondary to postoperative complications of Hirschsprung's disease as a cause of histopathologic changes typical of intestinal neuronal dysplasia.

Abstract:

PURPOSE:The aim of this study was to clarify the pathogenesis of intestinal neuronal dysplasia (IND). METHODS:The bowel habits of 36 postoperative HD patients were assessed retrospectively. Twenty-five had no complaints. Seven had persistent enterocolitis and were the focus of our study. They were divided into group A (n = 2) if they were severe and had associated postoperative surgical complications, and group B (n = 5) if they were mild. The histological changes were assessed. RESULTS:The 7 patients who had persistent enterocolitis postoperatively had no AchE activity in the mucosa, and there was normal distribution of submucosal and myenteric ganglia in the proximal resection margin. Rectal biopsies performed postoperatively for investigation of persistent enterocolitis in group A showed inflammatory changes and typical histopathologic features of IND such as abundant acetylcholinesterase (AchE)-positive nerve fibers in the lamina propria associated with giant submucosal ganglia and hyperganglionosis, and in group B there was increased AchE activity without hyperganglionosis or giant ganglia. CONCLUSIONS:This is the first report of histopathologic changes typical of IND occurring in response to persistent enterocolitis related to postoperative complications of surgery for HD.

journal_name

J Pediatr Surg

authors

Kobayashi H,Yamataka A,Lane GJ,Miyano T

doi

10.1016/j.jpedsurg.2003.10.008

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

152-6; discussion 152-6

issue

2

eissn

0022-3468

issn

1531-5037

pii

S0022346803007978

journal_volume

39

pub_type

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