title: Noniatrogenic neonatal gastric perforation: the role of interstitial cells of Cajal.
abstract: Noniatrogenic neonatal gastric perforation is a rare and life-threatening condition whose etiology is often unclear. Interstitial cells of Cajal act as gastrointestinal pacemaker cells and express the proto-oncogene c-Kit. Six new cases were identified at our institution which presented with no mechanical, pharmacologic, or otherwise medical-related intervention prior to rupture. The number of interstitial cells of Cajal in nonnecrotic muscularis propria from five random high-power fields per specimen was compared using immunohistochemical stains for c-Kit. The authors show that a lack of interstitial cells of Cajal in the stomach musculature may be implicated in the development of noniatrogenic gastric perforation (p = 0.008). Further large-scale studies, including molecular and genetic analysis, may help to better understand this phenomenon.
authors.affiliation: 1Pathology, Childrens Hospital of Atlanta -Egleston, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Samuel Noah
authors.initials: SN
authors.lastname: Jactel
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Abramowsky
authors.forename: Matthew
authors.initials: M
authors.lastname: Schniederjan
authors.forename: Megan M
authors.initials: MM
authors.lastname: Durham
authors.forename: Richard R
authors.initials: RR
authors.lastname: Ricketts
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Clifton
authors.forename: Karl M
authors.initials: KM
authors.lastname: Langberg
authors.forename: Nancy
authors.initials: N
authors.lastname: Elawabdeh
authors.forename: Samir
authors.initials: S
authors.lastname: Pandya
authors.forename: Sarah
authors.initials: S
authors.lastname: Talebagha
authors.forename: Bahig M
authors.initials: BM
authors.lastname: Shehata
mesh_terms: D016022:Case-Control Studies; D002452:Cell Count; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D056885:Interstitial Cells of Cajal / Q000378:metabolism / Q000473:pathology*; D008297:Male; D000090063:Proto-Oncogene Mas; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D012422:Rupture, Spontaneous; D013275:Stomach Rupture / Q000209:etiology* / Q000378:metabolism / Q000473:pathology
chemical_list: C000715470:MAS1 protein, human; D000090063:Proto-Oncogene Mas; D019009:Proto-Oncogene Proteins c-kit