Delayed maturation of interstitial cells of Cajal in meconium obstruction

Ultrasound-guided contrast enema for meconium obstruction in very low birth weight infants: Factors that affect treatment success

“…Among the patient factors, only gestational age, birth weight, and body weight affected the success of the procedure. Considering that the possible pathophysiology of the MO is immaturity of the bowel motility [6][7][8], VLBW infants with higher gestational age could have an increased chance of recovery after the water-soluble contrast enema. Body weight at birth and at the time of procedure could be another indice reflecting the maturation of bowel motility, and the association could be understood in the same way.…”

“…MO is thought to be due to the highly viscid meconium and the immature, poor motility of the bowels in preterm infants [4,6]. A few reports suggest that poor bowel motility can be associated with the immaturity of ganglia [6][7][8]. Whether this disease is the same or a separate entity compared to MPS is still debated [5,9,10].…”

Induction of Early Meconium Evacuation Promotes Feeding Tolerance in Very Low Birth Weight Infants

“…Weak peristalsis due to an immature colon is one possibility [11] , and perinatal risk factors such as maternal hypertension and the maternal use of magnesium sulfate increase the risks of intestinal hypoperfusion or smooth muscle depression [13] . Other possible causes include high mucoviscidosis of preterm meconium caused by a failure to progress distal hepaticopancreatic secretions [14] , and recently the delayed maturity of the interstitial cells of Cajal was also suggested to be a cause [15] . However, regardless of its etiology, the prevention and prompt management of meconium retention can reduce morbidity and mortality in VLBWI with physiological or pathological bowel dysfunction.…”

Necrotising enterocolitis and localised intestinal perforation: different diseases or ends of a spectrum of pathology

“…Distally propagated peristalsis does not occur in a coordinated fashion and a relative degree of intestinal obstruction occurs which may be so severe as to simulate Hirschsprung's disease [6]. More importantly, there may also be an abnormality of maturity and function of the Interstitial cells of Cajal (ICCs) in premature infants [7,8]. ICCs are characterised by autonomous rhythmical electrical depolerisation/ repolerisation of the cell membrane similar to the cardiac muscle pacemaker cells [9,10].…”

“…These are known as the ''pacemaker'' cells of the GI tract and are thought to perform the same function as cardiac pacemakers, by coordinating the inherent frequency of excitation/contraction coupling in intestinal smooth muscle cells [12][13][14][15]. This ''pacemaker'' function is believed to be central to normal peristalsis and when deficient, is thought to be associated with abnormal peristalsis and may thus cause a relative degree of intestinal obstruction [7]. It is known to be abnormal in certain types of LIP [16].…”