Segmental absence of intestinal musculature

Nandedkar, Shirish; Malukani, Kamal; Bandi, Prasann Kumar; Nayak, Renu

doi:10.1007/s12664-014-0446-2

Cited by 2 publications

(4 citation statements)

References 2 publications

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“…5). [16][17][18][19][20][21][22][23][24][25] Thus, SAIM in adults was considered to be an extremely rare disease. However, our study has revealed that it was the second highest cause of intestinal perforation.…”

Section: Discussionmentioning

confidence: 99%

“…Among the previously reported adult SAIM cases, information on age was available in 8. 16,17,[19][20][21][22][23][24][25] Of these, 3 patients (ages of 60, 64, and 68 y) had SAIM in the lower segments (sigmoid colon) and 5 (ages of 28, 34, 48, 64 y, and "middle age") had SAIM in the upper segments. Therefore, it is likely that SAIM of the upper segment is associated with younger age.…”

Section: Discussionmentioning

confidence: 99%

“…Among the previously reported cases, 7 also had similar diseases or events; namely, perforation during endoscopic polypectomy, adhesion due to ileus, postappendectomy, postrectal resection for rectal carcinoma, ileus due to rectal cancer, postresection of gangrenous bowel, and stool impaction due to severe constipation. 16,17,[20][21][22]25 Considering the patients' history, SAIM may be more prevalent than previously recognized, and perforations develop in the context of disease or interventions in the intestine, such as endoscopic treatment or and systemic chemotherapy. We also hypothesized that the perforation of the diverticulum might precede severe diverticulitis, and perforation of the SAIM might be related to an increase in internal intestinal pressure without severe inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, 15 cases of adult SAIM with perforations have been published in the literature. [17][18][19][20][21][22][23][24][25] No specific causes of perforation were identified from the patients' history and related pathologic findings in these reports. Notably, Tamai et al 21 stressed 2 unique points regarding adult SAIM: the absence of significant inflammatory cell infiltration around the perforated lesion and no recurrence of perforation.…”

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confidence: 99%

See 3 more Smart Citations

Prevalence and Clinicopathologic Features of Intestinal Perforation Caused by Segmental Absence of the Intestinal Musculature in Adults

Tsuyuki

Satou

Takahara

et al. 2021

American Journal of Surgical Pathology

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Segmental absence of the intestinal musculature (SAIM) can cause intestinal perforation in adults. However, its prevalence and clinicopathologic features have not been well-described. This study aimed to determine the prevalence of SAIM-associated perforation and characterize its clinicopathologic features. We retrospectively examined 109 cases of intestinal perforation that underwent surgical resection from January 2009 to December 2019. SAIM was defined as the complete absence of the muscularis propria without extensive inflammation and fibrinous exudation around the perforation. SAIM was the second most frequent cause of perforation (26 cases: 24%), the most frequent cause being related to diverticulitis (39 cases: 36%). The most common site was the sigmoid colon (12 cases: 46.2%). The younger group (aged below 65 y) exhibited more frequent perforation of the upper segments of the gastrointestinal tract (from the duodenum to the descending colon) than the older group (65 y and above) (P=0.0018). No patients developed recurrence. The most common gross features were well-defined circular or small punched-out lesions, and the histologic features were complete absence of the muscularis propria and absence of hemorrhage and necrosis around the area of perforation. The characteristic features of SAIM were unique and their prevalence was higher than previously reported. The precise recognition of SAIM can aid in understanding the cause of perforation and avoiding further unnecessary examinations.

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