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. 2019 Feb 19:12:2632010X19829263.
doi: 10.1177/2632010X19829263. eCollection 2019 Jan-Dec.

A Pilot Study on Histopathology of the Jejunoileal Atresia-Can it Be Used as a Guide to Determine the Length of Adequate Resection?

Anand Pandey  1 , Abhishek Singh  1 , Preeti Agarwal  2 , Archika Gupta  1 , Jiledar Rawat  1 , Shiv Narain Kureel  1
Affiliations

A Pilot Study on Histopathology of the Jejunoileal Atresia-Can it Be Used as a Guide to Determine the Length of Adequate Resection?

Anand Pandey et al. Clin Pathol. .

Abstract

Introduction: Some studies reported that there is abnormality in the histopathology of atretic bowel in jejunoileal atresia (JIA). We have made an attempt to assess sequential histopathologic changes in the resected atretic segment.

Material and methods: The histopathology of the resected segment was evaluated at 1, 3, 5, 7, 9, and 11 cm from atretic end (Sections A to F, respectively). The ratio of inner and outer muscle layer (measured by NIS-Element D software) was calculated at every section. Immunohistochemistry for α-smooth muscle actin (α-SMA) was also done. The findings were compared with control.

Results: In control set (n = 5), the ratio of inner and outer muscle layer was 1.03. In patients with JIA, the ratio was 0.68 to 0.9 at section A. This ratio varied at various sections in all specimens. In section F, this ratio was 0.95 to 1.09, which is close to control ratio. There were no specific findings related to α-SMA staining.

Conclusions: It appears that the bowel proximal to the atresia is abnormal for a varied length. It may be a possibility that this abnormality is present at least up to about 10 cm proximal to atresia. Adequate resection is important for optimal outcome.

Keywords: Atresia; histopathology; jejunoileal atresia.

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Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Line diagram of the distance from atretic end at which sections were taken for histopathological evaluation.
Figure 2.
Figure 2.
Photomicrograph showing 2 control specimens (A and B, HE ×400). The thickness was measures by NIS element software, which is visible.
Figure 3.
Figure 3.
Photomicrograph showing sections A to C of atresia (HE ×400). Both muscle layers are visible in sections A and B. Section C1 is showing inner circular muscle layer and section C2 is showing outer longitudinal layer. Muscle layer is thickest in section C1. The measured muscle thickness is depicted over the muscle layer.
Figure 4.
Figure 4.
Photomicrograph showing sections D to F of atresia (HE ×400). Both muscle layers are visible in these sections. The measured muscle thickness is depicted over the muscle layer. Last photomicrograph is showing fibrosis, which is encircled.
Figure 5.
Figure 5.
Diagrammatic representation of all specimens and control. It is obvious that all specimens have varied ratio of inner circular and outer longitudinal muscle layer. This is coming close to control ratio in section F.
See this image and copyright information in PMC

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