medigraphic.com
Patología Revista Latinoamericana

2013, Number 1

<< Back Next >>

Patol Rev Latinoam 2013; 51 (1)

Vascular lesions in intestinal atresia

Haro-Sánchez VJ, Ramón-García G, Valencia-Mayoral P

Language: Spanish
References: 21
Page: 13-17
PDF size: 462.00 Kb.


ABSTRACT

Background: Intestinal atresia is a common malformation of small intestine and is the most frequent cause of obstruction in neonates. Several causes have been described having all in common a vascular accident as a plausible explanation for its occurrence.
Objective: Description of vascular abnormalities in atretic segments and possible relationship to ischemic and vascular insult.
Methods: a descriptive, retrospective study. Cases with diagnosis of intestinal atresia were selected from the files of de department of pathology of Hospital Infantil de Mexico during a five year period from January 2004 to December 2008. Histological slides were reviewed with description of the vascular changes and were correlated with the type of atresia.
Results: 20 cases were retrieved, vascular alterations were found in all of them. Angiomatoid formations, irregularities in their walls, congestive dilated vessels, linfangiectasias and smooth muscle and fibroblastic proliferation were found. The type of atresia encountered were 8 type II, 6 cases of type IIIa, and 3 cases each for types IIIb and IV.
Conclusion: Vascular abnormalities are frequent in resected segments of intestinal atresia. They are concordant with a vascular derangement as a pathogenic factor supporting the theory of an ischemic event for this malformation.


REFERENCES

  1. Baeza Herrera C Patología Quirúrgica neonatal, 2ª ed. México DF, 1995:108-18.

  2. Grostfeld JL. Jejunoileal atresia and stenosis. En Welch KJ, Randolph JG, Raitch MM, O´Neil JA, Rowe WT(eds) Pediatric Surgery. Chicago, Year Medical Publishers 1986, Cap 85, pp. 838-848.

  3. Louw JH, Barnard N. Congenital intestinal atresia. Observations on its origin. Lancet 1955;2:1065-1067.

  4. Touloukian RJ, Diagnosis and treatment of jejunoileal atresia. Worl J Surg 1993;17:310-317.

  5. Hoyme HE, Higginbottom MC, jones KL, Vascular etiology of disruptive structural defects in monozygotic twins. Pediatrics 1981;67:288-291.

  6. AdejiyigibeO, Odeanmi WO. Intrauterine intussusception causing intestinal atresia. J Pediatr Surg 1990;25:562-563.

  7. Todani T, Tabuchi K, Tanaka S, intestinal atresia due to intrauterine intussusception. Analysis of 24 cases in Japan. J Pediatr Surg 1975;10:445-451.

  8. Black PR, Mueller D Crow J, Morris RC, Hussain A, Mesenteric defect as a cause of intestinal volvulus whitout malrotation ans as a possible primary etiology of intestinal atresia. J Peduiatr Surg 1994;29:1339-1343.

  9. Graham JM, Marin-Padilla M, Hoefnagel D. Jejunal atresia associated with cafergot® ingestion during pregnancy. Clinical Pediatr 1983;22:226-228.

  10. Gaillard D, Bouvier R, Scheiner C. Meconium ileus and intestinal atresia in fetuses and neonates. Pediatr Pathol Lab Med 1996;16:225-40.

  11. Tibboel D, VanNie CJm Molenaar JC, The effects of temporary general hypoxia and local ischemia on the development of the intestines: an experimental study. J Pediatr Surg 1980, 15: 57-62.

  12. Koga Y, Hayashida Y, Ikeda K, Inokuchi K, Hashimoto N. Intestinal atresia in fetal dogs produced by localized ligation of mesenteric vessels. J Pediatr Surg 1975;10:949-953.

  13. Santully TV, Blanc WA. Congenital atresia of the small intestine: Pathogenesis and treatment Ann Surg 1961;154:939-948.

  14. Abrams JS. Experimental intestinal atresia. Surgery 1968:185-191.

  15. Esterly JR, Oppenhaimer EH. Vascular lesion in infants with congenital rubella. Circulation 1967;36:544-554.

  16. Cogo A, Napolitano,G Michoud MC, Ramos Barbon,D y Martin JG. Effects of hypoxia on rat airway smooth muscle cell proliferation. J Appl Physiol 2003;94:1403–1409.

  17. Ismail S, Sturrock A, Wu P, Cahill B, Norman K, Huecksteadt T, Sanders K, Kennedy T, Hoidal J. NOX4 mediates hypoxia-induced proliferation of human pulmonary artery smooth muscle cells: the role of autocrine production of transforming growth factor-β1 and insulin-like growth factor binding protein-3. Am J Physiol Lung Cell Mol Physiol 2009;296:L489–L499.

  18. Shortera NA, Georgesa A, Perenyib A, Garrowa E. A proposed classification system for familial intestinal atresia and its relevance to the understanding of the etiology of jejunoileal atresia. Journal of Pediatric Surgery 2006;41:1822– 1825.

  19. Fairbanks TJ, Kanard RC, DeLanghe SP, et al. Colonic atresia without mesenteric vascular occlusion, the role of the fibroblast growth factor 10 signaling pathway. J Pediatr Surg 2005;40(2):390-7.

  20. Sadler TW, Rasmussen, SA. Examining the Evidence for Vascular Pathogenesis of Selected Birth Defects. Am J Med Genetics part A 2010;152A,10:2426-2436.

  21. Gupta T, Yang W, Iovannisci DM Carmichael SL ,Stevenson, D. K., Shaw, GM, Lammer, EJ. Considering a vascular pathogenesis of small intestinal atresia: risks associated with 32 single nucleotide polymorphisms involved in homocysteine metabolism, coagulation, cell-cell interactions, inflammatory response, and blood pressure regulation. Journal of Investigative Medicine 2012;60:202.




2020     |     www.medigraphic.com