[Peculiarities of a large bowel microstructure in children, suffering chronic constipation, caused by its inborn...

Area of Science:

• Pediatric Gastroenterology
• Gastrointestinal Pathology
• Electron Microscopy

Context:

• Chronic constipation (CHC) in children is often linked to congenital anomalies like dolichosigma.
• Understanding the underlying structural changes is crucial for effective treatment.
• Previous studies have not detailed the specific microstructural alterations in CHC associated with dolichosigma.

Purpose:

• To investigate the detailed microstructure of the sigmoid colon in children with CHC caused by dolichosigma using layer-by-layer electron microscopy.
• To identify specific pathological changes in the large bowel wall associated with this condition.

Summary:

• Electron microscopy of 20 sigmoid colon specimens revealed significant microstructural changes in all layers of the large bowel in children with CHC and dolichosigma.
• Observed changes include mucosal epithelium alterations, inhibited goblet cell secretion, edema, disordered filament structures, damaged blood vessels, and destructive changes in smooth muscle cells.
• Lymph node hyperemia and leukocytic infiltration indicate a reactive response of lymphoid tissue to these pathological changes.

Impact:

• The identified structural reorganization of the gut wall directly correlates with the severity and clinical course of CHC in children with dolichosigma.
• These morphological changes significantly inhibit the propulsive function of the sigmoid colon, leading to inadequate passage of bowel contents.
• Findings provide a deeper understanding of the pathophysiology of CHC in pediatric dolichosigma, potentially guiding future therapeutic strategies.