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We examined full-thickness rectal biopsies from 30 children who had chronic constipation, including 5 children with constipation associated with clinical symptoms of intestinal pseudo-obstruction. Biopsies from 9 patients who required colonic interposition and from 7 with Hirschsprung's disease were used as controls. Tissues were evaluated for muscularis mucosae thickness (in mm), for absolute circular and longitudinal muscle layer thicknesses and their ratio, and for the intensity of neural vasoactive intestinal peptide (VIP) immunohistochemical staining. Atrophy of the rectal musculature with focal muscle fiber vacuolation or muscle fiber disappearance was found in all children with chronic constipation. Muscularis mucosae thickness was increased (P < .01) and the circular-to-longitudinal muscle ratio was decreased in the constipation group, with the greatest degree of atrophy being demonstrated in the circular layer. Two of the patients had additional biopsies up to 9 years after the first that illustrate progressive myopathic changes over time. This study demonstrates muscular atrophy in the rectum of children with chronic constipation. Besides primary idiopathic disease, potential etiologies include chronic distention, denervation, functional obstruction from obstipation, alteration in gut hormones, and toxic, ischemic, or neural injury.
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
February 1984,
Pediatrics,
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
March 2023,
Pediatric gastroenterology, hepatology & nutrition,
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
February 1982,
The Journal of pediatrics,
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
April 1986,
The Journal of pediatrics,
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
June 2011,
Collegium antropologicum,
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
November 1988,
Lancet (London, England),
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
January 2020,
SAGE open medical case reports,
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
April 1980,
Zeitschrift fur Kinderchirurgie und Grenzgebiete,
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
May 1960,
International record of medicine,
R D Murray, and
S J Qualman, and
P Powers, and
D A Caniano, and
H J McClung, and
B Ulysses, and
K Li, and
L A Heitlinger
December 2012,
International urogynecology journal,
