title: Intestinal atresia with segmental musculature and neural defect.
abstract: OBJECTIVE
  The aim of this study was to investigate the possible etiologic factors of small bowel atresia and to detect the prognostic role of adequate resection and tapering in postoperative morbidity and mortality.
  
  
  METHODS
  Intestinal resection specimens were obtained from 10 patients with jejunoileal atresia and 3 control subjects without any gastrointestinal disease. Intestinal specimens taken from 2-cm and 4-cm proximal sides of atresia, atretic segment, and 1-cm and 2-cm distal sides of atresia were stained with Masson trichrome and H&E. Immunohistochemical staining of the biopsy specimens with synaptophysin was also performed to ascertain the number, the intensity, and the morphology of ganglia.
  
  
  RESULTS
  At the blind proximal end, there was segmental absence of muscular layers, presence of neural defects, and replacement of the muscular layers with fibrous tissue beside the relatively intact mucosa.
  
  
  CONCLUSIONS
  Segmental defects in muscular and neural structures of the intestinal wall observed in both the antimesenteric and mesenteric sides of the atretic small bowel were considered to support the vascular insult theory as an etiologic factor. Adequate resection rather than tapering the dilated proximal atretic intestinal segment should be included in the surgical treatment of this pathology to avoid the intestinal dysmotility, which may result in gut-related sepsis and death in the postoperative period.
authors.affiliation: Department of Pediatric Surgery, Süleyman Demirel University Medical School, Isparta, 32260, Turkey. ifozguner@hotmail.com
authors.forename: I Faruk
authors.initials: IF
authors.lastname: Ozguner
authors.forename: Cagri
authors.initials: C
authors.lastname: Savas
authors.forename: Meltem
authors.initials: M
authors.lastname: Ozguner
authors.forename: Ozden
authors.initials: O
authors.lastname: Candir
mesh_terms: D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D007082:Ileum / Q000002:abnormalities; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D007410:Intestinal Diseases / Q000209:etiology*; D007583:Jejunum / Q000002:abnormalities; D008297:Male; D009130:Muscle, Smooth / Q000002:abnormalities; D009197:Myenteric Plexus / Q000002:abnormalities*; D011183:Postoperative Complications; D012189:Retrospective Studies