Sensory nerve endings in puborectalis and anal region: normal findings in the newborn and changes in anorectal anomalies.
This study was carried out in five full-term newborn babies and 11 patients with anorectal anomalies (five of whom had high deformity, five had intermediate, and one had low), using the modified Bielschowsky method. The following four kinds of sensory nerve ending were found: muscle spindle in the puborectalis and the external anal sphincter, Pacinian corpuscle in the plane between the internal anal sphincter and the external anal sphincter and in the presacral space, globular ending in the presacral space, and free nerve ending in the epithelium of the anal canal and in the perianal skin. It was found that there were significantly fewer muscle spindles in the puborectalis and many fewer Pacinian corpuscles and globular endings in the presacral space of high and intermediate deformities than normal. No spindle was found in the external sphincteric muscles of the deformities. On the other hand, the Pacinian corpuscles and the globular endings of high and intermediate deformities lagged behind normal in development. The densities of the nerve bundles in the subepidermis and the nerve fibers in the dermis of perineal region in high and intermediate deformities were much lower than normal, and the decrease in density corresponded to the levels of the rectal pouch. The observation showed that the agenesis of sensory nerve endings in the puborectalis and the anal region was one of the most significant pathological features in high and intermediate types of anorectal anomalies, and might be responsible for the abnormalities of the reflex of the anal sphincter and the anal sensation in such patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Li
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Department of Pediatric Surgery, Third Affiliated Hospital of China Medical University, Shenyang.
Li
Z
Z
Hou
H S
HS
Wang
H Z
HZ
Wang
L Y
LY
D001003:Anal Canal / Q000002:abnormalities / Q000294:innervation* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D009470:Muscle Spindles / Q000473:pathology; D012007:Rectum / Q000002:abnormalities / Q000294:innervation* / Q000473:pathology; D011984:Sensory Receptor Cells / Q000473:pathology*