title: Myenteric plexitis: A frequent feature in patients undergoing surgery for colonic diverticular disease.
abstract: BACKGROUND
  Diverticular disease of the colon is frequent in clinical practice, and a large number of patients each year undergo surgical procedures worldwide for their symptoms. Thus, there is a need for better knowledge of the basic pathophysiologic mechanisms of this disease entity.
  
  
  OBJECTIVE
  Because patients with colonic diverticular disease have been shown to display abnormalities of the enteric nervous system, we assessed the frequency of myenteric plexitis (i.e. the infiltration of myenteric ganglions by inflammatory cells) in patients undergoing surgery for this condition.
  
  
  METHODS
  We analyzed archival resection samples from the proximal resection margins of 165 patients undergoing left hemicolectomy (60 emergency and 105 elective surgeries) for colonic diverticulitis, by histology and immunochemistry.
  
  
  RESULTS
  Overall, plexitis was present in almost 40% of patients. It was subdivided into an eosinophilic (48%) and a lymphocytic (52%) subtype. Plexitis was more frequent in younger patients; and it was more frequent in those undergoing emergency surgery (50%), compared to elective (28%) surgery (p = 0.007). All the severe cases of plexitis displayed the lymphocytic subtype.
  
  
  CONCLUSIONS
  In conclusion, myenteric plexitis is frequent in patients with colonic diverticular disease needing surgery, and it might be implicated in the pathogenesis of the disease.
authors.affiliation: Department of Medicine, University of Perugia School of Medicine, Perugia, Italy.
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
authors.affiliation: Pathology Institute, Spedali Civili, Brescia, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Villanacci
authors.affiliation: Department of Experimental Medicine, University of Perugia School of Medicine, Perugia, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Sidoni
authors.affiliation: Department of Medical and Surgical Sciences, University of Brescia School of Medicine, Brescia, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Nascimbeni
authors.affiliation: Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy ; Baylor College of Medicine, Houston, TX, USA.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Dore
authors.affiliation: Department of General Surgery, Galliera Hospital, Genova, Italy.
authors.forename: Gian A
authors.initials: GA
authors.lastname: Binda
authors.affiliation: Department of Pathology, Galliera Hospital, Genova, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bandelloni
authors.affiliation: Pathology Institute, Spedali Civili, Brescia, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Salemme
authors.affiliation: Department of Experimental Medicine, University of Perugia School of Medicine, Perugia, Italy.
authors.forename: Rachele
authors.initials: R
authors.lastname: Del Sordo
authors.affiliation: Pathology Institute, Spedali Civili, Brescia, Italy.
authors.forename: Moris
authors.initials: M
authors.lastname: Cadei
authors.affiliation: Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manca
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Nunzia
authors.initials: N
authors.lastname: Bernardini
authors.affiliation: Hospital of Baselland, University of Basel, Liestal, Switzerland.
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Maurer
authors.affiliation: Hospital of Baselland, University of Basel, Liestal, Switzerland.
authors.forename: Gieri
authors.initials: G
authors.lastname: Cathomas
keywords: Colon; diverticular disease; diverticulitis; hemicolectomy; histology; immunology; inflammation; myenteric plexitis; surgery