[Neuropathological study of the esophagus in cirrhotic patients with esophageal varices]

A neuropathological study was performed in autopsy specimens of the esophagus of 8 cirrhotic patients with large esophageal varices, in which cases marked dilatation as well as motility disorders of the esophagus were demonstrated by esophagography, esophagoscopy and esophageal manometry. Histological findings of the esophagus of cirrhotics were also compared to those of 7 control patients without esophageal or liver disease. Total and normal ganglion cell counts/cm2 at the Auerbach's plexus were found to have been significantly decreased, while the rate of the ganglion cells with the deformity of nucleus or with degenerated Nissl granules significantly increased at the upper, middle and, in particular, lower esophagus. Thus, the reduction of the number of and the degeneration of ganglion cells at the Auerbach's plexus in the esophagus of cirrhotic patients with large varices are clearly demonstrated, and it is further suggested that such neuropathological changes as described above may have contributed to, at least in part, the development of impaired motility of the esophagus with large varices.