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.
It is essential to establish baseline intestinal wall structural data in children with Hirschsprung’s disease (HSCR) before validating new imaging techniques for this population. The goals of this study are to compare ganglionic and aganglionic intestinal walls histologically, to determine whether or not the thickness of the intestine wall is correlated with patient weight, and to characterize the relationship between these variables.
This was a prospective study that analyzed stool samples from children weighing 0-10 kg who underwent surgery in rapid succession from 2018-2020. Digitized microscope pictures were collected from 10 spots per transverse specimen to evaluate the thickness of the histoanatomical layers of ganglionic and aganglionic bowel walls. About 21 kids had their bowel walls measured. There was no significant difference between aganglionic and ganglionic full bowel wall thickness (2.20 vs. 2.04; P=0.802), but there were positive correlations between weight at surgery and both 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, the muscularis externa layer was thicker in aganglionic segments than in ganglionosis (0.45 vs 0.31 mm, P=0.012), but the muscularis interna layer was smaller (0.45 vs 0.62 mm, P<0.001).
A lower ratio of muscularis interna/externa thickness and subsequent thinner muscularis interna were found to be a diagnostic index for aganglionic versus ganglionic bowel in all specimens. In children with HSCR, the muscular layers of the intestine wall are a different thickness in aganglionic versus ganglionic bowels. These results provide credence to a diagnostic index that might be verified for immediate diagnostic imaging if further research is conducted in this area.
Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03792-3