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[B型肠道神经元发育异常:我们如今如何理解它?]

[Intestinal neuronal dysplasia type B: how do we understand it today?].

作者信息

Bruder E, Meier-Ruge W A

机构信息

Institut für Pathologie, Universitätsspital Basel, Schönbeinstrasse 40, 4031 Basel, Switzerland.

出版信息

Pathologe. 2007 Mar;28(2):137-42. doi: 10.1007/s00292-007-0894-x.

Abstract

Intestinal neuronal dysplasia type B (IND B) is currently considered to be a subtle malformation of the submucosal plexus, leading to an increased proportion of over-sized ganglia and potentially accompanied by a mild, chronic gastrointestinal motility disturbance. The diagnosis of IND B is morphologically based and involves the demonstration of an increased proportion of giant ganglia in the submucous plexus related to the patient's age. Giant ganglia are physiologically frequent in the neonatal period. Therefore, IND B should not be diagnosed prior to 1 year of age. Morphological features of IND B may occur as an isolated finding or may be observed proximal to an aganglionic segment. IND B and constipation may resolve spontaneously up to the age of 4 years. Treatment of IND B is usually conservative, surgical resection is currently deemed necessary only in a minority of patients. The pathogenesis of IND B is still incompletely understood and the etiology unknown. Future research on the basis of standardized diagnostic conditions is expected to result in a better understanding of this disease, and to reveal the cause of aberrant ganglion development.

摘要

B型肠道神经元发育异常(IND B)目前被认为是黏膜下神经丛的一种细微畸形,导致超大神经节的比例增加,并可能伴有轻度慢性胃肠动力障碍。IND B的诊断基于形态学,包括证明黏膜下神经丛中与患者年龄相关的巨型神经节比例增加。巨型神经节在新生儿期在生理上很常见。因此,IND B不应在1岁之前诊断。IND B的形态学特征可能作为孤立发现出现,也可能在无神经节段近端观察到。IND B和便秘在4岁之前可能会自发缓解。IND B的治疗通常是保守的,目前仅在少数患者中认为有必要进行手术切除。IND B的发病机制仍未完全理解,病因不明。基于标准化诊断条件的未来研究有望更好地理解这种疾病,并揭示神经节异常发育的原因。

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