Pathohistological study of the ganglion plexuses of the sigmoid colon in patients with chronic slow-transit constipation

Abstract

The morphological study of the resected sections of the colon obtained at the S.P. Fedorov Department of Faculty Surgery of S.M. Kirov Military Medical Academy, as a result of surgical treatment of patients with severe chronic slow-transit constipation, included an assessment of the changes in the structures of ganglion plexuses. Three cases were considered (women, aged 3740 years). Various degrees of pathological changes were detected in the ganglion plexuses (Auerbach and Meissner) of the sigmoid colon from patients with chronic slow-transit constipation using Nissls toluidine blue staining. In all cases, reactive, dystrophic, severe degenerative-necrotic changes of ganglion cells, as well as the details of their death, were described in detail. Along with pathological changes in nerve cells in the myenteric nerve plexus and gliosis, features of neuronglial relationships were described, and the death of ganglion cells in the human colon with the active participation of specialized astrocyte-like glial cells was also established for the first time. In the third case, a pattern of pronounced dysplasia and dysgangliogenesis was revealed in the myenteric ganglion plexus of the sigmoid colon, and the presence of diffuse lymphmonocytic infiltrates was noted in the circular muscle layer. Pathological changes in the enteral nervous system in chronic slow-transit constipation reflect neuropathy, which can serve as the main cause of impaired intestinal functions and of some symptoms.

Immunohistochemical study of the sympathetic innervation of the colon in chronic slow-transit constipation

“…В настоящей работе у некоторых больных, особенно с признаками выраженного воспаления (гипертрофии ЛУ, увеличения лейкоцитарных инфильтратов, включая тучные клетки в области крипт), мы наблюдали заметное повышение плотности парасимпатических структур в слизистой и подслизистой оболочках. Эти данные свидетельствует о развитии хронического нейроиммунного воспаления у таких больных [25]. Ранее Lomax et al (2010) [5] отмечали взаимосвязь симпатических нервных волокон с иммунным воспалением в кишечнике.…”