Intestinal Connective tissue abnormality may cause Intestinal Desmosis[1][2] The absence of the tendinous plexus layer was first described in 1998 by Meier-Ruge.[3] Desmosis is implicated in disturbed gut motility.[citation needed]
Normal peristalsis depends upon the interaction between muscles, nerve cells and tendinous connective tissue. A malfunction of any of these leads to intestinal motility disorders. Desmosis may be congenital (aplastic form) or acquired (atrophic form).[citation needed]
The aplastic[4] form is rare. Typical clinical findings are hypoperistalsis, and pseudo-obstruction. These are found in premature infants, associated with low birth weight. The atrophic[5] form is more frequent. Inflammation of the muscularis propria releases enzymes including collagenases which destroy the connective tissue of the bowel wall. Primarily newborns and small children are affected, although this manifestation can also be found in adults. The most common location is the colon with a necrotizing enterocolitis as well as Crohn Disease and diverticulitis. If the taenia are also affected, the disease is defined as complete atrophic desmosis, all other forms without involvement of the taenia are referred to as incomplete. Clinically, patients demonstrate chronic constipation. As proposed by Giuseppe Martucciello,[6] microscopic diagnosis requires laparoscopic intestinal full-thickness biopsies from colon. Histological findings are absence of the tendinous plexus layer and connective tissue fibers in longitudinal and circular muscle layer.[2]
References
edit- ^ Holschneider, A.M.; Puri, P., eds. (2008). Hirschsprung's disease and allied disorders. Springer. doi:10.1007/978-3-540-33935-9. ISBN 978-3-540-33935-9.
- ^ a b Meier-Ruge WA, Bruder E (2005). "Pathology of chronic constipation in pediatric and adult coloproctology". Pathobiology. 72 (1–2): 1–102. doi:10.1159/000082310. PMID 15902901.
- ^ Meier-Ruge WA (October 1998). "Desmosis of the colon: a working hypothesis of primary chronic constipation". Eur J Pediatr Surg. 8 (5): 299–303. doi:10.1055/s-2008-1071218. PMID 9825241.
- ^ Meier-Ruge WA, Bruder E (March 2007). "[The morphological characteristics of aplastic and atrophic desmosis of the intestine]". Pathologe (in German). 28 (2): 149–54. doi:10.1007/s00292-007-0896-8. PMID 17279408.
- ^ Meier-Ruge & Bruder 2005, pp. 78–81, §Atrophic desmosis as secondary connective tissue atrophy in muscularis propria
- ^ Martucciello G (June 2008). "Hirschsprung's disease, one of the most difficult diagnoses in pediatric surgery: a review of the problems from clinical practice to the bench". Eur J Pediatr Surg. 18 (3): 140–9. doi:10.1055/s-2008-1038625. PMID 18493886.