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In Vitro Characterization of the Electrophysiological Properties of Colonic Afferent Fibers in Rats
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Myenteric plexus abnormalities associated with epiphrenic diverticula.

Thomas W Rice1, John R Goldblum, Martha M Yearsley

  • 1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|November 11, 2008
PubMed
Summary
This summary is machine-generated.

Myenteric plexus abnormalities are common in epiphrenic diverticulum, often linked to motility disorders and hiatal hernias. These histologic changes may explain distal obstruction, even in isolation.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Esophageal Physiology

Background:

  • Epiphrenic diverticulum is a rare condition often associated with esophageal motility disorders and hiatal hernias.
  • The underlying pathophysiology of epiphrenic diverticulum and its relationship with esophageal dysfunction remain incompletely understood.

Purpose of the Study:

  • To categorize histologic abnormalities of the esophageal myenteric plexus in patients with epiphrenic diverticulum.
  • To correlate these histologic findings with esophageal motility disorders and the presence of hiatal hernias.

Main Methods:

  • Analysis of esophageal muscle specimens from 40 patients who underwent surgery for epiphrenic diverticulum between 1987 and 2008.
  • Histologic evaluation included assessment of ganglion cell number, myenteric inflammation, and myenteric fibrosis.
  • Correlation with preoperative esophageal manometry and findings of hiatal hernia.

Main Results:

  • Myenteric plexus abnormalities were identified in 78% of patients.
  • Reduced or absent ganglion cells were observed in 53% of cases.
  • Myenteric inflammation (53%) and fibrosis (23%) were also prevalent, with distinct patterns associated with different motility disorders and hiatal hernias.

Conclusions:

  • Histologic abnormalities of the myenteric plexus are a predominant finding in epiphrenic diverticulum.
  • While disease-specific patterns exist, they are not always complete, suggesting multifactorial causes for distal obstruction.
  • Myenteric plexus abnormalities may be the sole finding in some cases of isolated epiphrenic diverticulum, potentially indicating limitations in current diagnostic techniques.