Department of Anatomical Sciences, St. George's University, West Indies.
Department of Anatomy, Varmia and Mazury Medical School, Olsztyn, Poland.
Clin Anat. 2022 Oct;35(7):1014-1024. doi: 10.1002/ca.23940. Epub 2022 Aug 5.
Chronic pain from untreatable abdominal cancers or pancreatitis can severely decrease an individual's quality of life due to accompanying neuropathic pain, the most difficult pain mechanism to treat. Current treatment modalities focus on peripheral block or neurolysis procedures of the sympathetic ganglia in an attempt to curb the pain and improve quality of life. Reports indicated that these treatments are ineffective with patients either experiencing no relief or return the pain in a few weeks. The aim of this study was to investigate the location, macro- and microscopic morphology, and interconnections of the abdominal ganglia. The abdominal sympathetic ganglia of nine adult cadavers were investigated. The locations, morphology, interconnections, and microscopic structure were studied in 108 potential abdominal ganglia. Particular emphasis was placed on direct interconnectivity between the ganglia and histological morphology. A total of 100 ganglia were confirmed histologically to contain ganglion cells. The number and locations of most of the ganglia identified in our study does not correspond to that described by previous reports. Numerous interconnections between the different ganglia, as well as direct communications with the lumbar sympathetic chain ganglia were observed. The interconnections and presence of ganglion cells the nerves connecting the ganglia lead to the belief that the system should be considered as a unit and that pain fibers may be transmitted via alternative previously undiscovered pathways. If the pain treatments are to be reassessed with this information in mind, we believe that greater success could be achieved.
由于伴随的神经病理性疼痛，无法治疗的腹部癌症或胰腺炎引起的慢性疼痛会严重降低个体的生活质量，这是最难治疗的疼痛机制。目前的治疗方法侧重于周围阻滞或交感神经节的神经松解术，试图抑制疼痛并提高生活质量。报告表明，这些治疗对患者无效，要么没有缓解，要么在几周内疼痛复发。本研究旨在探讨腹部神经节的位置、宏观和微观形态以及相互联系。研究了 9 具成人尸体的腹部交感神经节。研究了 108 个潜在腹部神经节的位置、形态、相互联系和微观结构。特别强调了神经节之间的直接连通性和组织学形态。共有 100 个神经节被组织学证实含有神经节细胞。我们研究中确定的大多数神经节的数量和位置与以前的报告中描述的不相符。观察到不同神经节之间有许多连接，以及与腰交感神经链神经的直接通讯。神经节之间的连接和神经节细胞的存在表明，该系统应被视为一个整体，并且疼痛纤维可能通过以前未发现的替代途径传递。如果在考虑这些信息的情况下重新评估疼痛治疗，我们相信可以取得更大的成功。
