title: Simultaneous degeneration of myenteric plexuses and pelvic parasympathetic colonic nerve in slow transit constipation: A case report.
abstract: BACKGROUND
  Slow transit constipation (STC) is a common disease of which the etiology is still not clear. Multiple hypotheses have been proposed to explain STC, including autonomic neuropathy, disorders of the enteric nervous system and so forth. Morphological abnormalities of the enteric nerves of the colon in patients with STC have been extensively reported, while there have been no morphological reports focusing on extrinsic extramural fibers from the pelvic plexus to the distal colon (i.e., pelvic parasympathetic colonic nerve) in patients with STC.
  
  
  METHODS
  Whether morphological changes of pelvic parasympathetic colonic nerve coexist with abnormalities of the enteric nerves of the colon in the patient with STC.
  
  
  METHODS
  Slow transit constipation (STC).
  
  
  METHODS
  The patient with STC underwent a partial colectomy (sigmoid colon and partial descending colon). The fibers of the myenteric plexuses within the removed colon and the myelinated fibers of the pelvic parasympathetic colonic nerve were observed under optical and electron-microscope.
  
  
  RESULTS
  The fibers of the myenteric plexuses showed vacuolated degeneration between the muscularis propria layer under optical microscope. Myelinated fibers of the pelvic parasympathetic colonic nerve showed obvious vacuolated degeneration under electron-microscopic examination.
  
  
  CONCLUSIONS
  Such a simultaneous neuropathy in both myenteric plexuses and extrinsic extramural nerves has not been documented previously. Our finding supports the notion that neuropathy remains the most plausible explanation for STC, in which nerve dysfunction might occur by way of a degenerative process.
authors.affiliation: Department of General Surgery, Qilu Hospital, Shandong University, Jinan Department of Medicine, No. 89 Hospital of PLA, Weifang, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Cheng
authors.forename: Kun
authors.initials: K
authors.lastname: Zhao
authors.forename: Dongsong
authors.initials: D
authors.lastname: Bi
mesh_terms: D003082:Colectomy / Q000379:methods; D003106:Colon / Q000294:innervation*; D003248:Constipation / Q000209:etiology* / Q000601:surgery; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D008875:Middle Aged; D009197:Myenteric Plexus / Q000473:pathology*; D010275:Parasympathetic Nervous System / Q000473:pathology*