Pathophysiology of aganglionic colon segment: An experimental study on aganglionosis produced by a new method in the rat

Abstract

Experimental aganglionosis was produced successfully in a colonic segment proximal to the peritoneal reflection by intraluminal filling under tension of the colorectum of rats with 0.01% corrosive sublimate in normal saline solution. Where the length of aganglionic segment was more than 3 cm, ileus appeared and megacolon proximal to a narrow segment was observed. Histologically and histochemically, a total denervation state was observed in the aganglionic segment, in contrast to findings in narrow segments of Hirschsprung's disease, in which intramural extraneous nerves are known to be increased. The fact that a definite narrow segment like that seen in Hirschsprung's disease appeared at the portion of the colon in which experimental aganglionosis was produced indicates that a narrow colonic segment certainly can be produced without presence of any intramural extraneous nerves, although the possibility that the presence of such nerves may exaggerate the narrowing cannot be denied. The fact that the cases in which length of aganglionosis was less than 2.5 cm did not have an ileus suggests that there may be some contributing factors other than aganglionosis in the etiology of Hirschsprung's disease of ultrashort segment, if this entity of the disease really exists. Aperistalsis observed in experimental aganglionic segments and that observed in aganglionotic segments of Hirschsprung's disease seem to be based on a common main factor, i.e., absence of the nonadrenergic, noncholinergic nerves.