Abstract
Intestinal muscle and the autonomic nervous system constitute a neuromuscular unit. A clinical study was undertaken to seek neurogenic causes of impaired motility affecting the rectosigmoid junction and rectum. Patients with primary chronic constipation were shown by enzyme-histochemical examination of biopsies to have neuronal colonic dysplasia of the rectosigmoid, whereas the latter was normally innervated in healthy controls. The present investigations provide a fresh insight, underpinned by histological findings, into the aetiology of chronic constipation and make a contribution to its operative treatment.
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References
Wienbeck M (1979) Motilítätsstörungen von Kolon und Anus als pathogenetisches Prinzip. Internist 20:18–23
Feussner H, Reiser SB, Schippers E, Siewert JR (1988) Pathophysiologische Grundlagen und therapeutische Konsequenzen bei Motilitätsstörungen am Darm. Chirurg 59:1–7
Meier-Ruge W (1983) Zur Pathogenese anorektaler Anomalien und Dysgangliosen. In: Hoffmann-v.Kap-herr S (ed) Anorektale Fehlbildungen. Fischer, Stuttgart New York, pp 19–22
Meier-Ruge W (1971) Über ein Erkrankungsbild des Colon mit Hirschsprung-Symptomatik. Verh Dtsch Ges Pathol 55:506–510
Meier-Ruge W (1985) Angeborene Dysganglionosen des Colon. Kinderarzt 16:151–164
Gulotta F, Straaten G (1977) Hirschsprung'sche Krankheit mit gleichzeitiger Aganglionose und sogenannter neuronaler Kolondysplasie (Dysganglionosis colica). Z Kinderchir 20:42–49
Fadda B, Maier WA, Meier-Ruge W, Schärli A, Daum R (1983) Neuronale intestinale Dysplasie. Eine kritische 10-Jahres-Analyse klinischer und bioptischer Diagnostik. Z Kinderchir 38:305–311
Scherer U (1987) Störungen der Kolonmotilität. In: Koelz HR, Aeberhard P (eds) Gastroenterologische Pathophysiologie. Springer, Berlin Heidelberg New York, pp 100–111
Read NW, Timms JM (1986) Defecation and the pathophysiology of constipation. Clin Gastroenterol 15:937–965
Martelli H, Devroede G, Arhan P, Duguay T, Dornic C, Fardin C (1978) Some parameters of large bowel motility in normal man. Gastroenterology 75:612–618
Hess R, Scarpelli DG, Pearse AGE (1958) The cytochemical localization of oxidative enzymes II. Pyridine nucleotide-liked dehydrogenasis. J Biophys Biochem Cytol 4:753–760
Karnovsky M, Roots C (1964) A “direct-coloring” thiocholine method for cholinesterase. J Histochem Cytochem 12:219–221
Nachlas MM, Margulies SI, Seligman AM (1960) Sites of electron transfer to tetrazolium salts in the succinoxidase system. J Biol Chem 235:2739–2743
Meier-Ruge W (1982) Morphological Diagnosis. In: Holschneider AM (ed) Hirschsprung's Disease. Hippokrates, Stuttgart Thieme-Stratton, New York, pp 62–71
Garret JR, Howard ER (1969) Histochemistry and the pathology of Hirschsprung's disease. Proc R Microsc Soc 4:76–78
Kamijo K, Hiatt RB, Koelle FB (1963) Congenital megacolon. A comparison of the spastic and hypertrophied segments with respect to cholinesterase activities and sensitivities to acetylcholine, DFP and barium ion. Gastroenterology 24:173–185
Koelle GB (1954) Autonomic and pharmacologic control of colonic activity. Ann NY Acad Sci 58:307–315
Niemi M, Konvalainen K, Hyelt L (1961) Cholinesterase and monoamine oxidase in congenital megacolon. J Pathol Bact 82:363–366
Connell AM, Hilton C, Irvine G, Lennard-Jones JE, Miesiewicz JJ (1965) Variation in bowel habit in two population samples. Br Med J ii:1095–1099
Wingate DL (1986) The tunnel at the end of the light. Gut 77:995–998
Smith B (1968) Effect of irritant purgatives on the myenteric plexus in man and mouse. Gut 9:139–143
Riemann JF, Zimmermann W (1978) Ultrastructural studies of colonic nerve plexuses in chronic laxative abuse. Gastroenterology 74:1085
Krishnamurthy S, Schuffler MD; Rohrmann CA, Pope CE (1985) Severe isiopathic constipation is associated with a distinctive abnormality of the colonic myenteric plexus. Gastroenterology 88:26–34
Schärli AF, Meier-Ruge W (1981) Localized and disseminated forms of neuronal intestinal sysplasia mimicking Hirschsprung's disease. J Pediatr Surg 16:164–170
Fadda B, Pistor G, Meier-Ruge W, Hoffmann-von Kap-herr S, Müntefering H, Espinoza R (1987) Symptoms, diagnosis and therapy of neuronal intestinal dysplasia masked by Hirschsprung's disease. Pediatr Surg Int 2:76–80
Goligher J (1984) Megacolon and idiopathic constipation in adults. In: Surgery of the anus, rectum and colon, 5th edn. Bailliere Tindall, London
Kußmann J, Thiele H (1988) Operative Therapie beim symptomatischen Megacolon des Erwachsenen. Chirurg 59:360–363
Preston DM, Hawley PR, Lennard-Jones JE, Todd IP (1984) Results of colectomy for severe idiopathic constipation in women (Arbuthnot Lane's disease). Br J Surg 71:547–552
Anuras S, Shirazi SS (1984) Colonic pseudoobstruction. Am J Gastroenterol 79:525–532
Raguse T (1987) Chirurgische Aspekte—chronisch hartnäckige Obstipation. In: Hotz J, Rösch W (eds) Funktionelle Störungen des Verdauungstraktes. Springer, Berlin Heidelberg New York, pp 210–215
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Stoss, F. Neuronal dysplasia. Int J Colorect Dis 5, 106–112 (1990). https://doi.org/10.1007/BF00298481
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DOI: https://doi.org/10.1007/BF00298481