Pathology of idiopathic megarectum and megacolon

被引:42
作者
Gattuso, JM [1 ]
Kamm, MA [1 ]
Talbot, IC [1 ]
机构
[1] ST MARKS HOSP,LONDON EC1V 2PS,ENGLAND
关键词
idiopathic megarectum; idiopathic megacolon;
D O I
10.1136/gut.41.2.252
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background-The aetiology and pathology of both idiopathic megarectum and idiopathic megacolon are unknown. in particular, it-is unknown whether there are abnormalities involving enteric nerves or smooth muscle. Methods-Resected tissue was examined from 24 patients who underwent surgery for idiopathic megarectum, from sis patients who had tissue resected for idiopathic megacolon, and 17 control patients who had surgery for non-obstructing large bowel cancer. Qualitative and quantitative histological examination was performed after staining with haematoxylin and eosin, periodic acid Schiff (PAS), Martius scarlet blue (MSB), and phosphotungstic acid haematoxylin (PTAH), Neural and glial tissue were examined after immuno-staining with S100 and PGP9.5. Results-Compared with controls, patients with idiopathic megarectum had significant thickening of their muscularis mucosae (median 78 v 33 mu m, p<0.005), circular muscle (1000 v 633 mu m, p<0.005), and longitudinal muscle (1083 v 303 mu m, p<0.005), despite rectal dilatation. This thickening was relatively greater in the longitudinal than in the circular muscle. Fibrosis of the longitudinal muscle was seen, using MSB staining, in 58%, of circular muscle in 38%, and of muscularis mucosae in 29% of patients. The relation between muscle thickening and fibrosis was variable. The density of neural tissue in the longitudinal muscle seemed to be reduced in patients with idiopathic megarectum, There was no thickening of enteric muscle or alteration in the density of innervation in patients with idiopathic megacolon. Conclusion-There is notable thickening of the enteric smooth muscle in patients with idiopathic megarectum, but the architecture of the enteric innervation seems to be intact, Functional abnormalities of the latter remain a possible cause of the smooth muscle hypertrophy.
引用
收藏
页码:252 / 257
页数:6
相关论文
共 33 条
  • [1] HIRSCHSPRUNGS-DISEASE AND IDIOPATHIC MEGACOLON IN ADULTS AND ADOLESCENTS
    BARNES, PRH
    LENNARDJONES, JE
    HAWLEY, PR
    TODD, IP
    [J]. GUT, 1986, 27 (05) : 534 - 541
  • [2] INVOLVEMENT OF NITRIC-OXIDE IN THE INHIBITORY INNERVATION OF THE HUMAN ISOLATED COLON
    BOECKXSTAENS, GE
    PELCKMANS, PA
    HERMAN, AG
    VANMAERCKE, YM
    [J]. GASTROENTEROLOGY, 1993, 104 (03) : 690 - 697
  • [3] NG-NITRO-L-ARGININE REDUCES NONADRENERGIC, NONCHOLINERGIC RELAXATIONS OF HUMAN GUT
    BURLEIGH, DE
    [J]. GASTROENTEROLOGY, 1992, 102 (02) : 679 - 683
  • [4] PEPTIDE-CONTAINING NEURONS IN DIFFERENT REGIONS OF THE SUBMUCOUS PLEXUS OF HUMAN SIGMOID COLON
    CROWE, R
    KAMM, MA
    BURNSTOCK, G
    LENNARDJONES, JE
    [J]. GASTROENTEROLOGY, 1992, 102 (02) : 461 - 467
  • [5] DUHAMEL B, 1966, ARCH DIS CHILD, V41, P150
  • [6] HOWARD ER, 1984, J ROY SOC MED, V77, P13
  • [7] HOYLE CHV, 1989, J ANAT, V166, P7
  • [8] HUIZINGA JD, 1992, J PHARMACOL EXP THER, V260, P803
  • [9] MANAGEMENT OF IDIOPATHIC MEGARECTUM AND MEGACOLON
    KAMM, MA
    STABILE, G
    [J]. BRITISH JOURNAL OF SURGERY, 1991, 78 (08) : 899 - 900
  • [10] KAMM MA, 1993, HOSP UPDATE, V19, P280