Hirschsprung’s Disease: Its Aetiology, Pathogenesis and Differential Diagnosis

Meier‐Ruge, W.

doi:10.1007/978-3-642-65857-0_4

Cited by 98 publications

(29 citation statements)

References 111 publications

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“…The introduction of enzyme histochemical acetylcholinesterase (ACHE) and dehydrogenase reactions in the routine diagnosis of I-Iirschsprung's disease (aganglionosis) [30,32,33,34,35,36] has resulted in the identification of abnormalities of the submucosal plexus [29]. Description and understanding of intestinal neuronal dysplasia (IND), accompanied by symptoms of pseudo-obstruction is incomplete, since 1983 when Fadda et al [9] first distinguished two different types of abnormality of vegetative gut innervation: IND of the sympathetic innervation of the colon (IND type A) and IND of the submucosal plexus (IND type B).…”

Section: Introductionmentioning

confidence: 99%

Histopathological criteria for intestinal neuronal dysplasia of the submucosal plexus (type B)

Meier‐Ruge

Brönnimann

Gambazzi

et al. 1995

Vichows Archiv A Pathol Anat

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The aim of this study was to review critically the diagnostic features of intestinal neuronal dysplasia type B (IND B). Over a period of 5 years colonic mucosal biopsies of 773 children with symptoms of chronic constipation were examined. Four biopsies taken 2-10 cm above the pectinate line were cut in serial sections and histochemical lactate dehydrogenase, succinate dehydrogenase, (SDH) and acetylcholinesterase (AChE) reactions performed. Presence of giant ganglia of the submucosal plexus, being characterized by more than seven nerve cells, established the diagnosis of IND B. Giant ganglia were found to be age-independent changes, while hyperplasia of the submucosal plexus, increase of AChE activity in nerve fibres of the lamina propria and low SDH activity in nerve cells proved to be age-dependent findings which disappear during the maturation of the enteric nervous system. Using these criteria IND B was diagnosed in 209 children. In 64 of these patients a combination of IND B and aganglionosis (Hirschsprung's disease) was found. IND B seems to be related to premature expression of laminin A during embryogenesis, resulting in premature nerve cell differentiation in the myenteric and submucosal plexus, which in turn blocks neuroblast colonization of the rectum. IND B, hypoganglionosis and aganglionosis, which are often combined, may therefore be considered to be different manifestations of the same developmental abnormality.

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Section: Introductionmentioning

confidence: 99%

Histopathological criteria for intestinal neuronal dysplasia of the submucosal plexus (type B)

Meier‐Ruge

Brönnimann

Gambazzi

et al. 1995

Vichows Archiv A Pathol Anat

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“…(11) Teenage improved vigilance and high social sanctions against incontinence increased treatment compliance and eventual improvement.…”

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confidence: 99%

Management of chronic constipation.

Clayden¹

1992

Archives of Disease in Childhood

116

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“…Anfang der 70er Jahren gelang es Meier-Ruge [17], mit Hilfe enzymhistochemischer Methoden weitere intestinale neuronale Fehlbildungen zu beschreiben. Bei diesen non aganglionfiren Formen handelte es sich vorwiegend um quantitativ-strukturelle Abweichungen von den normalen Innervationsverhfi.ltnissen der Darmwand, das heil3t, um hypo-bzw.…”

Section: Klassifikation Intestinaler Innervationsst6rungenunclassified

Intestinale Innervationsstörungen: Anatomische Grundlagen und Diagnostik

et al. 1999

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Histopathological insights into intestinal innervation disorders require the knowledge of the anatomical topography and structure of the enteric nervous system (ENS). The ENS of the human colon is composed of intramural nerve meshes located in different layers of the intestinal wall (plexus musculares, plexus myentericus, plexus submucosi, plexus mucosi). A differentiated visualization of the components of the ENS is achieved by enzyme-and immunohistochemical methods. In comparison to cross-sections, wholemount preparations of the intestinal wall allow a two

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Hirschsprung’s Disease: Its Aetiology, Pathogenesis and Differential Diagnosis

Cited by 98 publications

References 111 publications

Histopathological criteria for intestinal neuronal dysplasia of the submucosal plexus (type B)

Histopathological criteria for intestinal neuronal dysplasia of the submucosal plexus (type B)

Management of chronic constipation.

Intestinale Innervationsstörungen: Anatomische Grundlagen und Diagnostik

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