Hypercellular/heterotopic ganglia in omphalomesenteric duct remnants

Area of Science:

• Gastroenterology
• Pathology
• Developmental Biology

Background:

• Omphalomesenteric duct remnants (ODR), including Meckel diverticula, are congenital anomalies often presenting with bowel obstruction.
• Histologic examination of ODR typically reveals heterotopic gastrointestinal or pancreatic tissue.
• Abnormalities in the submucosal plexus of Meissner within ODR have not been previously documented.

Purpose of the Study:

• To investigate the presence and characteristics of ganglion abnormalities in the submucosal plexus of ODR.
• To determine if these abnormalities are associated with clinical presentation, particularly bowel obstruction.
• To compare the histologic features of ODR ganglia with known conditions like intestinal neuronal dysplasia type B.

Main Methods:

• Retrospective analysis of 53 ODR cases and 25 control small bowel specimens.
• Histologic examination to identify abnormal hypercellular/heterotopic ganglia (HHG) based on defined criteria (e.g., neuron count per field, location).
• Statistical analysis to compare the incidence of HHG in ODR versus controls and in relation to clinical factors (obstruction, inflammation, heterotopia).

Main Results:

• Abnormal hypercellular/heterotopic ganglia (HHG) were found in 51.9% of ODR cases, significantly higher than in controls (4%, P = 3.6 x 10(-6)).
• HHG were more prevalent in ODR excised for obstructive complications (65.7%) compared to those without acute abdomen (33.3%, P = 0.035).
• The incidence of HHG was similar in inflamed versus noninflamed ODR and in ODR with versus without heterotopic tissue.

Conclusions:

• ODR frequently harbor HHG, histomorphologically similar to those seen in intestinal neuronal dysplasia type B.
• The increased prevalence of HHG in symptomatic ODR suggests a potential association with bowel obstruction.
• No significant relationship was found between HHG and inflammation or heterotopic tissue within ODR.