Devi Subbarayan1, Meeta Singh2, Nita Khurana3, Agarwal Sathish4. 1. Assistant Professor, Department of Pathology, Chettinad Hospital and Research Institute (CHRI) , Kelambakkam, Chennai, India . 2. Senior Resident, Department of Pathology, GB Pant Hospital , Delhi, India . 3. Professor, Department of Pathology, Maulana Azad Medical College , Delhi, India . 4. Professor, Department of Paediatric Surgery, Maulana Azad Medical College , Delhi, India .
Abstract
INTRODUCTION: Intestinal atresia accounts for approximately one third of all cases of neonatal intestinal obstruction. There is controversy regarding pathogenesis of congenital atresia and stenosis of small bowel. Studies regarding clinical manifestations and specific histopathological features of neonatal intestinal atresia are scarce in Indian literature. AIM: To understand the histomorphological features and thus suggest pathophysiology of cases with Intestinal Atresia. MATERIALS AND METHODS: Out of 147 cases, of intestinal obstruction in newborn studied over a period of 5 years, 39 cases of intestinal atresia were found. Their histomorphological details with clinical manifestations were studied. RESULTS: Type II was the commonest type of atresia. Associated anomalies noted were gastroschisis, volvulus, anal stenosis, microcolon, annular pancreas, meconium cyst and duplication cyst. Histological changes observed were ulceration, flattening, abnormal villous configuration, luminal obliteration, narrowing, haemangiomatous proliferation of blood vessels, fibrosis, haemorrhage, calcification, and mesenchymal condensation around the blood vessels. Gangrene and perforation has also noted in some cases. CONCLUSION: An intrauterine intestinal ischemia due to vascular pathology followed by resorption of the bowel is the possible explanation for the development of intestinal atresia.
INTRODUCTION:Intestinal atresia accounts for approximately one third of all cases of neonatal intestinal obstruction. There is controversy regarding pathogenesis of congenital atresia and stenosis of small bowel. Studies regarding clinical manifestations and specific histopathological features of neonatal intestinal atresia are scarce in Indian literature. AIM: To understand the histomorphological features and thus suggest pathophysiology of cases with Intestinal Atresia. MATERIALS AND METHODS: Out of 147 cases, of intestinal obstruction in newborn studied over a period of 5 years, 39 cases of intestinal atresia were found. Their histomorphological details with clinical manifestations were studied. RESULTS: Type II was the commonest type of atresia. Associated anomalies noted were gastroschisis, volvulus, anal stenosis, microcolon, annular pancreas, meconium cyst and duplication cyst. Histological changes observed were ulceration, flattening, abnormal villous configuration, luminal obliteration, narrowing, haemangiomatous proliferation of blood vessels, fibrosis, haemorrhage, calcification, and mesenchymal condensation around the blood vessels. Gangrene and perforation has also noted in some cases. CONCLUSION: An intrauterine intestinal ischemia due to vascular pathology followed by resorption of the bowel is the possible explanation for the development of intestinal atresia.
Authors: Maaike W Schaart; Takeshi Yamanouchi; Danielle J P M van Nispen; Rolien H C Raatgeep; Johannes B van Goudoever; Ronald R de Krijger; Dick Tibboel; Alexandra W C Einerhand; Ingrid B Renes Journal: J Pediatr Gastroenterol Nutr Date: 2006-11 Impact factor: 2.839