Pathological Changes Of Enteric Neurons And Smooth Muscle In Infants With Intestinal Atresia And Their Relation To Prognosis

BACKGROUND:Intestinal atresia is a common disease in congenital intestinal malformations.Even after surgery,there are still some children with long-term complications,such as intestinal dysmotility.The present study primarily focuses on the pathological changes of the nerves,muscles,and intestinal Cajal cells of the proximal and distal intestine from atresia.No data have been published regarding the relation between the prognosis of the patients and morphologic differences of the intramural components of obstructed sites in intestinal atresiaMETHODS:Operative intestinal samples from cases of infants with jejunoileal atresia were collected in our study.All the patients have been followed up for more than 1 year.All the specimens were immunohistochemically stained with antibodies to ?3-tubulin,?-smooth muscle actin,and CD-3 proteinRESULT:In this study,18 infants were enrolled.Half of them(n=9)developed postoperative intestinal dysmotility,and the symptom of bowel obstruction could not be relieved in 4 of 9,leading to re-operation.In the immunohistochemical staining of the intestinal samples(n=53),we found that the number of neuronal cells decreased in size and number.The circular musculature was moderately to severely hypertrophic.Further,the proximal ones showed more severe pathological changes(p<0.05).In addition,the samples from the patients who developed postoperative intestinal dysmotility were more likely to have pathological changes(p<0.05).CONCLUSION:According to the results,we suspect that the intestinal pathological changes proximal to the atresia in children with congenital intestinal atresia are one of the causes of postoperative intestinal motility disorders,and a rational anastomotic position determined with the help of intraoperative frozen-section examination may help to reduce the occurrence of postoperative intestinal motility disorder.