Histopathological findings in enteric nervous plexuses in children with intestinal motility disorders – A Single Center Experience

  • Radmila Janković Faculty of Medicine, University of Belgrafe, Institute of Pathology https://orcid.org/0000-0001-5733-9505
  • Sanja Sinđić Antunović Department of Pediatric Surgery, University Children´s Hospital, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia https://orcid.org/0000-0002-9794-9743
  • Miloš Đuknić University of Belgrade, Faculty of Medicine, Institute of Pathology “Prof. dr Đorđe Joannović”, Belgrade, Serbia https://orcid.org/0000-0002-2315-7380
  • Dragana Vujović University of Belgrade, Faculty of Medicine, Institute of Pathology “Prof. dr Đorđe Joannović”, Belgrade, Serbia https://orcid.org/0009-0003-5329-5439
  • Nina Ristić Department of Gastroenterohepatology, University Children´s Hospital, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia https://orcid.org/0000-0003-2731-3042
  • Jovan Jevtić University of Belgrade, Faculty of Medicine, Institute of Pathology “Prof. dr Đorđe Joannović”, Belgrade, Serbia https://orcid.org/0000-0002-3424-4623
  • Djordje Toplicic Department of Pediatric Surgery, University Children´s Hospital, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Milena Backović Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
  • Nenad Zdujić Department of Pediatric Surgery, University Children´s Hospital, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Dunja Putniković University of Belgrade, Faculty of Medicine, Belgrade, Serbia https://orcid.org/0009-0000-6958-7792
  • Marija Lukač Department of Pediatric Surgery, University Children´s Hospital, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
DOI: https://doi.org/10.5937/medi57-49963
Keywords: Hirschsprung disease, suctional biopsy, full thickness biopsy, intestinal motility disorders

Abstract


Introduction/Aim: The aim of study was to determine the frequency of various histopathological findings in biopsies of children with intestinal hypomotility and determination of the incidence and characteristics of Hirschsprung disease (HD).

Methods: Biopsies of colon and rectum taken due to intestinal hypomotility and chronic constipation at the Department of pediatric surgery University Children´s Hospital in Belgrade over the 10-year period of 2009 to 2018 were reviewed using pathology reports from the archive of Institute of pathology, Medical Faculty University of Belgrade.

Results: A total of 287 patients with intestinal motility disorder were identified, with 554 biopsy samples. Out of all patients, 56% (161/287) was without any morphological changes in enteric nervous system (ENS). The most common histopathological findings were HD (69/287; 24%) and immaturity of ganglion cells (29/287; 10%). Isolated hypoganglionosis of ENS was found in 5 (2%) cases. Heterotopia of ganglion cells was the only finding in 8 (3%) cases. Rare causes of intestinal dysmotility were: eosinophilic proctitis/colitis (EPC) (4/287), neuronal intestinal dysplasia B (2/287), unclassified disganglionoses (3/287). Rectosigmoid variant of HD was the most frequent HD variant (80.3%). Acetylcholinesterase method and immunohistochemical staining were used in 19.5% cases.

Conclusions: HD and immaturity of ganglion cells were the most common pathological findings in ENS of constipated children. It is important to differentiate EPC from the other lesions of enteric plexuses due to different natural history and therapy.

Published
2024/09/10
Issue
Vol. 57 No. 3 (2024): Medicinska istraživanja
Section
Članci