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Nervous structure of Meckel's diverticulum in children

V Negrea1, D Gheban

  • 1Clinic of Pediatric Surgery and Orthopedics, Department of Pediatric Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. voicu.negrea@yahoo.com

Romanian Journal of Morphology and Embryology = Revue Roumaine De Morphologie Et Embryologie
|September 20, 2012
PubMed

Insights

Meckel's diverticulum nerve density varies by tissue type, impacting peristalsis and complications. Enteric mucosa shows higher nerve density, leading to increased intussusception risk, while gastric mucosa has lower density, impairing drainage.

Area of Science:

  • Gastroenterology and Surgical Pathology
  • Neurogastroenterology
  • Congenital Malformations

Background:

  • Meckel's diverticulum is the most common digestive tract malformation, yet its complete physiopathology remains unclear.
  • Understanding the role of the nervous system in Meckel's diverticulum is crucial for explaining its natural history and complications.

Purpose of the Study:

  • To investigate the relationship between the nervous system, specifically myenteric nerve fiber density, and the mucosal type (enteric vs. gastric heterotopia) within Meckel's diverticulum.
  • To elucidate how variations in nerve density influence local peristalsis and contribute to Meckel's diverticulum-related complications.

Main Methods:

  • Analysis of eight Meckel's diverticulum samples using specific immunohistochemical markers to assess nerve fiber density.
  • Comparison of myenteric nerve fiber density in areas with enteric mucosa, gastric heterotopia, and transition zones.
  • Evaluation of nerve density in the adjacent ileal wall and intradiverticular areas.

Main Results:

  • Significantly higher myenteric nerve fiber density was observed in areas with enteric mucosa compared to gastric heterotopias.
  • The transition zone showed intermediate nerve fiber density, while the adjacent ileal wall had a density similar to the gastric mucosa area.
  • Lower nerve density in gastric heterotopia areas correlated with less effective drainage and increased acid exposure, while higher density in enteric areas was linked to more intense peristalsis.

Conclusions:

  • Myenteric plexus density in Meckel's diverticulum directly influences local peristalsis, with higher density in enteric mucosa promoting complications like intussusception.
  • Gastric heterotopia in Meckel's diverticulum, associated with lower nerve density, leads to impaired drainage and potential mucosal damage.
  • Age-related decrease in nerve fiber density may explain the higher incidence of Meckel's diverticulum complications in children.

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