An inflammatory axonopathy of the myenteric plexus producing a rapidly progressive intestinal pseudoobstruction. 1986

S Krishnamurthy, and M D Schuffler, and L Belic, and A I Schweid

A previously well 39-yr-old man presented with a 4-wk history of abdominal pain, nausea, vomiting, and weight loss. An upper gastrointestinal examination showed retained food in the stomach and duodenal dilatation. A radioisotope meal showed little gastric emptying; esophageal manometry was normal. Because of persistent symptoms, a duodenojejunostomy was done. However, the patient remained symptomatic and after an episode of profuse vomiting, aspirated and died 10 wk after initial presentation. At autopsy, no tumor was found. Hematoxylin and eosin stains throughout the gastrointestinal tract showed many lymphocytes and plasma cells within the myenteric plexus. Silver stains showed the argyrophilic and argyrophobic neurons to be normal, but axons showed beading, fragmentation, and dropout in all areas. We therefore concluded the following: intestinal pseudoobstruction can be caused by an inflammatory neuropathy of the myenteric plexus, not associated with a distant carcinoma, and this process produced an axonopathy while sparing neuron bodies.

UI MeSH Term Description Entries
D007415 Intestinal Obstruction Any impairment, arrest, or reversal of the normal flow of INTESTINAL CONTENTS toward the ANAL CANAL. Intestinal Obstructions,Obstruction, Intestinal
D007418 Intestinal Pseudo-Obstruction A type of ILEUS, a functional not mechanical obstruction of the INTESTINES. This syndrome is caused by a large number of disorders involving the smooth muscles (MUSCLE, SMOOTH) or the NERVOUS SYSTEM. CIPO,Chronic Idiopathic Intestinal Pseudo-Obstruction,Paralytic Ileus,Pseudo-Obstruction, Intestinal,Visceral Myopathy,Congenital Short Bowel Syndrome,Enteric Neuropathy,Intestinal Pseudo-Obstruction, Idiopathic,Intestinal Pseudoobstruction,Pseudointestinal Obstruction Syndrome,Pseudoobstructive Syndrome,Chronic Idiopathic Intestinal Pseudo Obstruction,Enteric Neuropathies,Idiopathic Intestinal Pseudo-Obstruction,Idiopathic Intestinal Pseudo-Obstructions,Intestinal Pseudo Obstruction,Intestinal Pseudo Obstruction, Idiopathic,Intestinal Pseudo-Obstructions,Intestinal Pseudo-Obstructions, Idiopathic,Intestinal Pseudoobstructions,Myopathy, Visceral,Neuropathy, Enteric,Obstruction Syndrome, Pseudointestinal,Pseudo Obstruction, Intestinal,Pseudointestinal Obstruction Syndromes,Pseudoobstruction, Intestinal,Pseudoobstructive Syndromes,Syndrome, Pseudointestinal Obstruction,Syndrome, Pseudoobstructive,Visceral Myopathies
D008214 Lymphocytes White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each), or NATURAL KILLER CELLS. Lymphoid Cells,Cell, Lymphoid,Cells, Lymphoid,Lymphocyte,Lymphoid Cell
D008297 Male Males
D009197 Myenteric Plexus One of two ganglionated neural networks which together form the ENTERIC NERVOUS SYSTEM. The myenteric (Auerbach's) plexus is located between the longitudinal and circular muscle layers of the gut. Its neurons project to the circular muscle, to other myenteric ganglia, to submucosal ganglia, or directly to the epithelium, and play an important role in regulating and patterning gut motility. (From FASEB J 1989;3:127-38) Auerbach's Plexus,Auerbach Plexus,Auerbachs Plexus,Plexus, Auerbach's,Plexus, Myenteric
D009443 Neuritis A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include PAIN; PARESTHESIAS; PARESIS; or HYPESTHESIA. Polyneuritis,Neuritis, Motor,Neuritis, Peripheral,Neuritis, Sensory,Motor Neuritides,Motor Neuritis,Neuritides,Neuritides, Motor,Neuritides, Peripheral,Neuritides, Sensory,Peripheral Neuritides,Peripheral Neuritis,Polyneuritides,Sensory Neuritides,Sensory Neuritis
D004378 Duodenal Diseases Pathological conditions in the DUODENUM region of the small intestine (INTESTINE, SMALL). Disease, Duodenal,Diseases, Duodenal,Duodenal Disease
D004386 Duodenum The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers. Duodenums
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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