HISTOLOGIC AND EMBRYOLOGIC STUDIES ON THE INNERVATION OF THE PELVIC VISCERA IN PATIENTS WITH HIRSCHSPRUNGS-DISEASE

  • 1 January 1982
    • journal article
    • research article
    • Vol. 155  (6) , 823-828
Abstract
In specimens taken at autopsy from 3 newborns with Hirschsprung''s disease and 3 newborns in the control group, innervation of the pelvic organs was histologically studied. All the pelvic organs, except for the rectum in patients with Hirschsprung''s disease, preserved a completely normal innervation not only of pelvic autonomic nerve plexuses but also of sensory nerves of spinal origin. Even in the wall of the aganglionic rectum, the extrinsic sympathetic as well as parasympathetic nerve fibers were preserved, which showed a marked proliferative change due to the absence of target nerve cells upon which they otherwise terminated. An additional embryologic study was performed upon 20 human embryos. The pelvic nerve plexuses were formed during the 6-10 gestation wk period of neural cells migrating along the pelvic visceral branches of the sacral nerves; none of these neural cells entered the rectum. The enteric plexuses of the rectum were formed later by neural cells that migrated down alont the alimentary tract in a craniocaudel manner. The 2 separate origins, the sacral for the pelvic nerve plexuses and the vagal for the enteric plexuses of the rectum, seem to be the reason that innervation of the genitourinary organs, which are located in front of the aganglionic rectum, is normal in patients with Hirschsprung''s disease.