Guidelines Clinical Practice
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World J Gastroenterol. Jan 14, 2009; 15(2): 192-197
Published online Jan 14, 2009. doi: 10.3748/wjg.15.192
New techniques in the tissue diagnosis of gastrointestinal neuromuscular diseases
Charles H Knowles, Joanne E Martin
Charles H Knowles, Joanne E Martin, Neurogastroenterology Group, Centres for Academic Surgery and Pathology, Institute of Cellular and Molecular Science, Barts and the London, Queen Mary’s School of Medicine and Dentistry, Whitechapel, London, United Kingdom
Author contributions: Knowles CH wrote the manuscript; Martin JE edited the manuscript and provided the figures.
Correspondence to: Charles H Knowles, MBBChir, PhD, FRCS, FRCS (Gen), Clinical Senior Lecturer and Hon Consultant Surgeon, Barts and the London NHS Trust and the Homerton University NHS Foundation Trust, Centres for Academic Surgery, 3rd Floor Alexandra Wing, Royal London Hospital, London E1 1BB, United Kingdom. c.h.knowles@qmul.ac.uk
Telephone: +44-207-8828757
Fax: +44-207-3777346
Received: September 10, 2008
Revised: November 13, 2008
Accepted: November 20, 2008
Published online: January 14, 2009
Abstract

Gastrointestinal neuromuscular diseases are a clinically heterogeneous group of disorders of children and adults in which symptoms are presumed or proven to arise as a result of neuromuscular (including interstitial cell of Cajal) dysfunction. Common to most of these diseases are symptoms of impaired motor activity which manifest as slowed or obstructed transit with or without evidence of transient or persistent radiological visceral dilatation. A variety of histopathological techniques and allied investigations are being increasingly applied to tissue biopsies from such patients. This review outlines some of the more recent advances in this field, particularly in the most contentious area of small bowel disease manifesting as intestinal pseudo-obstruction.

Keywords: Enteric myopathy, Enteric neuropathy, Interstitial cells of Cajal, Intestinal pseudo-obstruction, Visceral pain