Surgical Treatment of a Sigmoid Volvulus Associated with Megacolon: Report of a Case

Kudaka, Manabu; Kudaka, Hiroshi; Tomiyama, Takeshi; Yogi, Mitsuo; Inafuku, Yukio; Kawano, Kouji; Yamashiro, Kazuya; Ooshiro, Kensei; Teruya, Tsuyoshi; Taira, Katsumi; Higa, Takeshi; Sunagawa, Hiroki

doi:10.1007/s005950070012

Cited by 7 publications

(2 citation statements)

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“…9,15,17 The intestinal peristaltic reflex is mediated via the ENS, and NANC excitatory nerves have been found to bring about proximal side contraction while NANC inhibitory nerves cause distal side relaxation of the bowel. 17 Previous reports suggest that the innervation contains both NANC excitatory and inhibitory nerves and that the latter are dominant.…”

Section: Discussionmentioning

confidence: 99%

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Role of the Enteric Nervous System in the Elongated Sigmoid Colon of Patients With Sigmoid Volvulus

Tomita

Sugitou

Sakurai

et al. 2014

International Surgery

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To clarify the physiologic function of the enteric nervous system (ENS) in the elongated sigmoid colon (ESC) of patients with sigmoid volvulus (SV), we examined the enteric nerve responses in lesional and normal longitudinal muscle strips (LMS) derived from patients with ESC and patients who underwent colon resection for colonic cancers. Thirty preparations of LMS were taken from the lesional sigmoid colons of 10 ESC patients with SV (8 men and 2 women, aged 53 to 80 years, mean 66.2 years). Forty preparations of LMS were taken from the normal sigmoid colons (NSC) of 20 patients with colonic cancer (12 men and 8 women, aged 55 to 76 years, mean 62.3 years). A mechanographic technique was used to evaluate in vitro muscle responses to electrical field stimulation (EFS) before and after treatment with various autonomic nerve blockers. Response to EFS before blockade of the adrenergic and cholinergic nerves was as follows: NSC and ESC significantly demonstrated relaxation reaction rather than contraction reaction (P ¼ 0.0253, P , 0.0001, respectively). ESC showed relaxation reaction more than NSC (P ¼ 0.1138). Response to EFS after blockade of the adrenergic and cholinergic nerves was as follows: NSC and ESC significantly demonstrated relaxation reaction via nonadrenergic noncholinergic (NANC) inhibitory nerves rather than contraction reaction via NANC excitatory nerves (P , 0.0001, P , 0.0001, respectively). ESC with SV significantly showed relaxation reaction more than NSC (P ¼ 0.0092). An increased response of relaxation mediated NANC inhibitory nerves may play a role in impaired motility in the ESC of patients with SV.

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Section: Discussionmentioning

confidence: 99%

“…5À8 However, there are some reports that ENS in the colon of ESC with SV is normal. 9,10 Histopathologic findings in the colon of ESC with SV are still inconclusive.…”

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confidence: 99%