Abstract
In pyloric stenosis, investigations of the histological pathology have concentrated on neuromuscular changes. These have shown a decrease in the innervation of the hypertrophied circular muscle and variable changes in the myenteric plexus. This study shows that the extracellular matrix (ECM) molecules have characteristic patterns in pyloric stenosis: chondroitin sulfate was markedly increased, with smaller increases in fibronectin and laminin. The increase in chondroitin sulfate was present in patients who were only several weeks old, with a short history, and in whom there was minimal circular muscle hypertrophy, and therefore was an early feature. It is not possible to ascribe aetiological significance to the increase in ECM molecules; nevertheless, the increase of chondroitin sulfate is the most likely explanation for the characteristic “cartilaginous” quality of the pyloric swelling.
Similar content being viewed by others
References
Alarotu H (1956) The histopathologic changes in the myenteric plexus of the pylorus in hypertrophic pyloric stenosis of infants (pylorospasm). Acta Paediatr 45: Suppl 107: 1–131
Belding HH, Kernohan JW (1953) A morphologic study of the myenteric plexus and musculature of the pylorus with special reference to the changes in hypertrophic pyloric stenosis. Surg Gynecol Obstet 97: 322–334
Bertolotto A, Palmucci L, Gagliano A, Ongini T, Tarone G (1986) Immunohistochemical localisation of chondroitin sulfate in normal and pathological human muscle. J Neurol Sci 73: 233–244
Bond G (1988) The normal infantile human pylorus — a study of its structure, with particular reference to its peptidergic innervation. B Sc (Med) theseis: Sydney University.
Cass DT, Zhang AL (1991) Neuromuscular changes in pyloric stenosis (in preparation)
Friesen SR, Boley JO, Miller DR (1956) The myenteric plexus of the pylorus: its early normal development and its changes in hypertrophic pyloric stenosis. Surgery 39: 21–29
Friesen SR, Everson-Pease AG (1963) Pathogenesis of congenital pyloric stenosis: histochemical analyses of pyloric ganglion cells. Surgery 53: 604–608
Havenith MG, Van Zandvoort EHM, Cleutjens JPM, Bosman FT (1989) Basement membrane deposition in benign and malignant naevo-melanocytic lesions: an immunohistochemical study with antibodies to type IV collagen and laminin. Histopathology 15: 137–146
Heinegard D, Sommarin Y (1987) Proteoglycans: an overview. In: Cunningham LW (ed) Methods in enzymology, Vol. 144: structural and contractile proteins. Part D, Extracellular matrix. Academic press, Orlando New York Sydney Tokyo pp 305–319
Kleinman HK, Weeks BS (1989) Laminin structure, functions and receptors. Curr Opin Cell Biol 1: 964–967
Malmfors G, Sunder F (1986) Peptidergic innervation in infantile hypertrophic pyloric stenosis. J Ped Surg 21: 303–306
Newgreen DF, Scheel M, Kastner V (1986) Morphogenesis of sclerotome and neural crest in avian embryos. In vivo and in vitro studies on the role of notocaudal extracellular material. Cell Tissue Res. 244: 299–313
Nielsen OS (1956) Histological changes of the pyloric myenteric plexus in infantile pyloric stenosis — studies on surgical biopsy specimens. Acta Paediatr 45: 636–647
Perris R, Johansson S (1990) Inhibition of neural crest cell migration by aggregating chondroitin sulfate proteoglycan is mediated by their hyaluronan-binding region. Dev. Biol. 137: 1–12
Rintoul JR, Kirkman NF (1961) The myenteric plexus in infantile hypertrophic pyloric stenosis. Arch Dis Child 36: 474–480
Rollins MD, Shields MD, Quinn RJM, et al (1989) Pyloric stenosis: congenital or acquired? Arch Dis Child 64: 138–147
Ruoslahti E (1988) Structure and biology of proteoglycans. Ann Rev Cell Biol 4: 229–255
Saint-Marie G (1962) A paraffin embedding technique for studies employing immunofluorescence. J Histochem Cytochem 10: 250–256
Spicer RD (1982) Infantile hypertrophic pyloric stenosis: a review. Br J Surg 69: 128–135
Tam PKH (1985) Observations and perspectives of the pathology and possible aetiology of infantile hypertrophic pyloric stenosis — a histological, biochemical, histochemical and immunocytochemical study. Ann Acad Med 14: 523–529
Wallgren A (1946) Preclinical stage of infantile hypertrophic pyloric stenosis. Am J Dis Child 72: 371–376
Wattchow DA, Cass DT, Furness JB, Costa M, et al (1987) Abnormalities of peptide containing nerve fibers in infantile hypertrophic pyloric stenosis. Gastroenterology 92: 443–448
Weston JA, Ciment G, Girdlestone J (1984) The role of extracellular matrix in neural crest development: a reevaluation. In: Trelstad RL (ed) The role of extracellular matrix in development. Alan R Liss, Inc New York. pp 433–460
Westra SJ, deGroot CJ, Smits NJ, Staalman CR (1989) Hypertrophic pyloric stenosis: use of the pyloric volume measurement in early US diagnosis. Radiology 172: 615–619
Yamada KM (1989) Fibronectins: structure, functions and receptors. Curr Opin Cell Biol 1: 956–963
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cass, D.T., Zhang, A.L. Extracellular matrix changes in congenital hypertrophic pyloric stenosis. Pediatr Surg Int 6, 190–194 (1991). https://doi.org/10.1007/BF00176066
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00176066