Clinical Study of Intestinal Pacemaker Cells in Neonates With Small Bowel Atresia

Anusiri Inugala ¹, Satyanarayana Ravula ²

⁰Pediatric Surgery, Institute of Child Health Niloufer Hospital, Hyderabad, IND.

Cureus +

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December 25, 2025

View abstract on PubMed

Summary

Reduced interstitial cells of Cajal (ICCs) in small bowel atresia correlate with poor outcomes. Higher ICC density predicts better postoperative bowel function and survival in neonates.

Area Of Science

Neonatal surgery
Gastroenterology
Histopathology

Background

Small bowel atresia is a primary cause of neonatal intestinal obstruction.
Postoperative gastrointestinal dysmotility is a common complication.
The role of interstitial cells of Cajal (ICCs) in this context is under-investigated.

Purpose Of The Study

To evaluate ICC density and distribution in neonates with small bowel atresia.
To correlate ICC presence with postoperative outcomes.
To investigate ICCs in atretic, proximal, and distal bowel segments.

Main Methods

Prospective study of 44 neonates with small bowel atresia.
Histological and immunohistochemical analysis of resected bowel segments using anti-CD117 (c-Kit).
Correlation of ICC distribution with clinical parameters and survival.

Main Results

Sparse or absent ICCs were found in atretic/proximal segments of neonates with delayed bowel function.
Higher ICC expression correlated significantly with earlier stool passage.
Improved survival was associated with greater ICC expression (p < 0.05).

Conclusions

Reduced ICCs are a key pathological finding in small bowel atresia.
ICC density is a significant determinant of postoperative bowel motility and survival.
ICC assessment can serve as a prognostic tool and aid surgical planning.

Keywords:

immunohistochemistry interstitial cells of cajal neonatal intestinal obstruction postoperative outcome small bowel atresia