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Histopathological dimensions differ between aganglionic and ganglionic bowel wall in children with Hirschsprung’s disease

Graneli, Christina LU ; Patarroyo, Sofia ; Mitev, Rodrigo Munoz ; Gisselsson, David LU ; Gottberg, Emilia ; Erlöv, Tobias LU ; Jansson, Tomas LU ; Hagelsteen, Kristine LU orcid ; Cinthio, Magnus LU and Stenström, Pernilla LU orcid (2022) In BMC Pediatrics 22.
Abstract

Background: In the validation of new imaging technology for children with Hirschsprung’s disease (HSCR), basic anatomical parameters of the bowel wall must be established specifically for this patient group. Aim: To explore differences in histoanatomical layers of bowel wall, comparing ganglionic and aganglionic bowel walls, and to examine if the bowel wall thickness is linked to patient weight. Methods: This was an observational study of bowel specimens from children weighing 0–10 kg, operated on consecutively during 2018–2020. Ganglionic and aganglionic bowel walls were measured in digitalized microscopy images from 10 sites per trans-sectional specimen and compared regarding the thickness of their histoanatomical layers. Results:... (More)

Background: In the validation of new imaging technology for children with Hirschsprung’s disease (HSCR), basic anatomical parameters of the bowel wall must be established specifically for this patient group. Aim: To explore differences in histoanatomical layers of bowel wall, comparing ganglionic and aganglionic bowel walls, and to examine if the bowel wall thickness is linked to patient weight. Methods: This was an observational study of bowel specimens from children weighing 0–10 kg, operated on consecutively during 2018–2020. Ganglionic and aganglionic bowel walls were measured in digitalized microscopy images from 10 sites per trans-sectional specimen and compared regarding the thickness of their histoanatomical layers. Results: Bowel walls were measured in 21 children. Full bowel wall thickness did not differ between aganglionic and ganglionic bowel (2.20 vs 2.04; p = 0.802) while weight at surgery correlated positively with both ganglionic and aganglionic bowel wall thickness (r = 0.688 and 0.849, respectively), and age at surgery with ganglionic bowel wall thickness (r = 0.517). In aganglionic segments, the muscularis externa layer was thicker compared to that in ganglionosis (0.45 vs 0.31 mm, p = 0.012) whereas the muscularis interna was thinner (0.45 vs 0.62 mm, p < 0.001). A diagnostic index was identified whereby a lower ratio of muscularis interna/externa thickness followed by a thinner muscularis interna differed between aganglionic and ganglionic bowel in all specimens. Conclusion: Thicknesses of the bowel wall’s muscle layers differ between aganglionic and ganglionic bowel walls in children with HSCR. These findings support a diagnostic index that could be validated for transfer to instant diagnostic imaging techniques.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aganglionosis, Bowel wall, Children, Ganglionosis, Hirchsprung’s disease, Histopathology
in
BMC Pediatrics
volume
22
article number
723
pages
10 pages
publisher
BioMed Central (BMC)
external identifiers
  • pmid:36536313
  • scopus:85144332899
ISSN
1471-2431
DOI
10.1186/s12887-022-03792-3
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2022, The Author(s).
id
96897400-2731-4c8e-9bbb-8d9a4944365a
date added to LUP
2023-01-07 08:32:42
date last changed
2024-04-15 12:57:16
@article{96897400-2731-4c8e-9bbb-8d9a4944365a,
  abstract     = {{<p>Background: In the validation of new imaging technology for children with Hirschsprung’s disease (HSCR), basic anatomical parameters of the bowel wall must be established specifically for this patient group. Aim: To explore differences in histoanatomical layers of bowel wall, comparing ganglionic and aganglionic bowel walls, and to examine if the bowel wall thickness is linked to patient weight. Methods: This was an observational study of bowel specimens from children weighing 0–10 kg, operated on consecutively during 2018–2020. Ganglionic and aganglionic bowel walls were measured in digitalized microscopy images from 10 sites per trans-sectional specimen and compared regarding the thickness of their histoanatomical layers. Results: Bowel walls were measured in 21 children. Full bowel wall thickness did not differ between aganglionic and ganglionic bowel (2.20 vs 2.04; p = 0.802) while weight at surgery correlated positively with both ganglionic and aganglionic bowel wall thickness (r = 0.688 and 0.849, respectively), and age at surgery with ganglionic bowel wall thickness (r = 0.517). In aganglionic segments, the muscularis externa layer was thicker compared to that in ganglionosis (0.45 vs 0.31 mm, p = 0.012) whereas the muscularis interna was thinner (0.45 vs 0.62 mm, p &lt; 0.001). A diagnostic index was identified whereby a lower ratio of muscularis interna/externa thickness followed by a thinner muscularis interna differed between aganglionic and ganglionic bowel in all specimens. Conclusion: Thicknesses of the bowel wall’s muscle layers differ between aganglionic and ganglionic bowel walls in children with HSCR. These findings support a diagnostic index that could be validated for transfer to instant diagnostic imaging techniques.</p>}},
  author       = {{Graneli, Christina and Patarroyo, Sofia and Mitev, Rodrigo Munoz and Gisselsson, David and Gottberg, Emilia and Erlöv, Tobias and Jansson, Tomas and Hagelsteen, Kristine and Cinthio, Magnus and Stenström, Pernilla}},
  issn         = {{1471-2431}},
  keywords     = {{Aganglionosis; Bowel wall; Children; Ganglionosis; Hirchsprung’s disease; Histopathology}},
  language     = {{eng}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Pediatrics}},
  title        = {{Histopathological dimensions differ between aganglionic and ganglionic bowel wall in children with Hirschsprung’s disease}},
  url          = {{http://dx.doi.org/10.1186/s12887-022-03792-3}},
  doi          = {{10.1186/s12887-022-03792-3}},
  volume       = {{22}},
  year         = {{2022}},
}