The following is the summary of “Histopathological dimensions differ between aganglionic and ganglionic bowel wall in children with Hirschsprung’s disease” published in the December 2022 issue of  Pediatrics by Graneli, et al.

Basic anatomical parameters of the gut wall must be established for this patient group specifically to validate novel imaging technology for children with Hirschsprung’s disease (HSCR). The goals of this study are to compare ganglionic and aganglionic bowel walls histologically and to determine whether the thickness correlates with patient weight. Children weighing 0-10 kg who underwent recurrent surgeries in 2018-2020 had intestinal specimens collected for this observational study. Comparing the thickness of the histoanatomical layers of ganglionic and aganglionic bowel walls, researchers analyzed digitized microscope pictures from 10 places per trans-sectional specimen.

About  21 kids had their bowel walls measured. There was no significant difference between aganglionic and ganglionic bowel in terms of full bowel wall thickness (2.20 vs. 2.04; P=0.802), but there were positive correlations between weight at surgery and ganglionic and aganglionic bowel wall thickness (r=0.688 and r=0.849, respectively) and between age at surgery and ganglionic bowel wall thickness (r=0.517). In addition, aganglionic segments had a thicker muscularis externa layer (0.45 mm vs. 0.31 mm, P=0.012) and a thinner muscularis interna layer (0.45 mm vs. 0.62 mm, P<0.001) than ganglionic segments. 

The ratio of muscularis interna/externa thickness ratio was shown to be significantly different between aganglionic and ganglionic bowel in all specimens, serving as a diagnostic index. In children with HSCR, aganglionic and ganglionic intestinal walls have different muscle layer thicknesses. These results support a diagnostic index that might be verified for application to real-time diagnostic imaging methods.