[Idiopathic megacolon. New findings on histopathology and musculo-mechanical causes]

Nineteen native surgical specimens of an idiopathic megacolon were histopathologically investigated and a lack of the tendon-like collagen III movement net of circular and longitudinal muscles observed, including a lack of the connective tissue layer of myenteric plexus. This disease of the muscularis propria could be considered as a desmolysis, a hypoplastic or an aplastic desmosis. With reference to the normal muscle mechanics of the gut, it is shown that the pathogenetic principle of the idiopathic megacolon consists in absence of the tendon-like connective tissue net in the muscularis propria which results in a lack of peristalsis of the gut, despite of a regular enteric innervation. This finding demonstrates that an idiopathic megacolon can be histopathologically verified in whole-mount biopsies and referred for curative surgical treatment.