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Full thickness biopsy findings in chronic intestinal pseudo-obstruction and enteric dysmotility
  1. Greger Lindberg (greger.lindberg{at}ki.se)
  1. Karolinska Institutet, Sweden
    1. Hans Törnblom (hans.tornblom{at}karolinska.se)
    1. Karolinska Institutet, Sweden
      1. Marie Iwarzon (marie.iwarzon{at}ki.se)
      1. Karolinska Institutet, Sweden
        1. Björn Nyberg (bjorn.nyberg{at}karolinska.se)
        1. Karolinska Institutet, Sweden
          1. Jo Martin (j.e.martin{at}qmul.ac.uk)
          1. Queen Mary University of London, United Kingdom
            1. Bela Veress (bela.veress{at}skane.se)
            1. Malmo General Hospital, Sweden

              Abstract

              Background & Aims: Small bowel manometry is increasingly used in the clinical investigation of patients with symptoms of intestinal motor dysfunction. Enteric dysmotility (ED) has been suggested as a new diagnostic term for patients with abnormal intestinal motor activity but no radiological signs of chronic intestinal pseudo-obstruction (CIP). We have compared histopathological features of adult patients with ED and CIP in a large case series to study differences and similarities between the two diagnostic groups.

              Methods: We used routine staining and an extensive panel of immunohistochemical stains on transversal and tangential cuts from full thickness biopsies of the small bowel.

              Results: We investigated 39 females and 11 males with CIP and 58 females and 7 males with ED. The underlying lesion was more often a visceral myopathy (22% vs. 5%) or neuro-myopathy (30% vs. 12%) in patients with CIP than in those with ED, whereas the predominant lesion in ED was neuropathy with inflammation.

              Conclusion: CIP in adults is associated with much different underlying pathology, whereas ED is more homogeneously associated with neuropathy in the enteric nervous system. Neuropathy of enteric ganglia with inflammation seems to be the most common cause for measurable disturbances of intestinal motor function.

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