ヒルシュスプルング病腸管の,いわゆる組織学的移行帯における神経節細胞の分布

概要

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The authors had had an impression that the point of termination of ganglionated transitional zone in Hirschsprung's disease is different between the mesenteric and antimesenteric side of the bowel. In order to clarify this hypothesis, entire circumference of the specimens of the bowel taken from 9 cases with Hirschsprung's disease were examined histologically by means of serial blocks. Distribution of ganglion cells and proliferated nerve fibers are examined by H & E stained semiserial sections. The study revealed the presence of histological transitional zone with irregular width. The principal findings were as follows. (1) The distribution of ganglion cells always advanced more distally at the antimesenteric side. (2) Difference of termination of my enteric plexus between antimesenteric and mesenteric side ranged 12 to 39 mm. (3) Some of the submucosal plexus were found more distally than my enteric plexus. (4) In some cases, the histological transitional zones were located 7 to 12 cm proximally from the macroscopical caliber change. It is suggested that submucosal ganglion cells could migrate independently through the submucosa. For frozen section during the operation, histological examination should be done on both antimesenteric and mesenteric sides after ring-shaped segmental resection, or should be done at the mesenteric side if only one biopsy was taken.
日本小児外科学会の論文
1986-11-02