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Myenteric plexus in spastic motility disorders.

J K Champion1, N Delise, T Hunt

  • 1Department of Surgery, Mercer University School of Medicine, Atlanta, GA, U.S.A. JKChamp@Juno.com

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|May 3, 2002
PubMed
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Patients with hypertensive lower esophageal sphincter lack ganglia in Auerbach's plexus, similar to achalasia. Nutcracker esophagus and diffuse esophageal spasm patients retain ganglia, showing no correlation with lower esophageal sphincter pressure.

Area of Science:

  • Gastroenterology
  • Esophageal Motility Disorders
  • Neuropathology

Background:

  • Achalasia is characterized by absent or reduced ganglia in Auerbach's plexus, linked to elevated lower esophageal sphincter pressure.
  • The myenteric plexus in other esophageal motility disorders requires further investigation regarding ganglia presence and its correlation with sphincter pressure.

Purpose of the Study:

  • To investigate microscopic changes in the myenteric plexus of patients with hypertensive lower esophageal sphincter, nutcracker esophagus, and diffuse esophageal spasm.
  • To determine the correlation between the presence of ganglia and lower esophageal sphincter pressure in these conditions.

Main Methods:

  • Prospective study of nine patients undergoing laparoscopic esophagomyotomy.
  • Analysis of esophageal muscle segments under light microscopy for ganglia and inflammation.

Related Experiment Videos

  • Correlation analysis between ganglia presence and lower esophageal sphincter pressure using Pearson's bivariant correlation.

    • Main Results:

    • Absence of ganglia in Auerbach's plexus was observed in all three hypertensive lower esophageal sphincter patients.
    • Ganglia were present in all six patients with nutcracker esophagus and diffuse esophageal spasm, despite elevated lower esophageal sphincter pressure in four.
    • No significant correlation was found between ganglia presence and elevated lower esophageal sphincter pressure in spastic motility disorders.

    Conclusions:

    • Hypertensive lower esophageal sphincter shares the absence of Auerbach's plexus ganglia with achalasia.
    • Nutcracker esophagus and diffuse esophageal spasm patients retain ganglia, differentiating them from achalasia.
    • The presence of ganglia in these spastic disorders does not correlate with lower esophageal sphincter pressure levels.