Changes in the Number of Interstitial Cells of Cajal in the Gastrointestinal Tract in Mechanical Ileus

Abstract

Background: The Interstitial cells of Cajal(ICC) were named by the Nobel Prize winner, the Spanish neuroanatomist Santiago Ramony Cajal (1852-1934). Interstitial cells of Cajal are mesenchymal cells in the stroma of the gut smooth muscle that are present between the nerve and smooth muscle and function as pacemaker cells because of the active generation of depolarized electrical slow waves of the smooth muscle system. In the human digestive tract, ICC are found in or around the myometrial lining of the esophagus, stomach, small intestine and large intestine. Mechanical ileus causes compensatory hyperperistalsis to resolve the initial obstruction, and ultimately results in decompensated peristalsis. The aim: We aimed to investigate the changes in the number of ICC cells in the clinical picture of mechanical ileus. Methods: The study population included 90 bowel resections accepted by the pathology department for mechanical ileus and 24 bowel resections from autopsy without digestive tract disease. Twenty-four autopsies (20-30 years) without digestive tract disease (from the body), small intestine (20 cm above ileum) and large intestine (from the ileocecal region) were obtained, and H-E and silver nitrate staining (Silver staining) specimens were prepared according to the conventional tissue sampling technique and the number of normal cord stromal cells under ×400 light microscope was calculated. H-E stained samples of bowel resection specimens from patients with mechanical ileus and silver nitrate stained samples were calculated as the number of Interstitial cells of Cajal (under ×400 light microscope, distributed between the cricoid and the longitudinal muscles) according to the site of development of the gastrointestinal tract and the number of days of the first defecation. At this time, pathological examination was performed on the lesion center and surrounding histopathology microscopically, and the interpretation of the changes in the number of Interstitial cells of Cajal was performed around the lesion because the anterior intestinal layer was completely necrotic in the lesion center and no normal structure was found. Results and Conclusions:  The changes in the number of normal ICC cells in the gastrointestinal tract and ICC by GI site in mechanical ileus are as follows : 1) Normal ICC in the gastrointestinal tract was significantly enriched in the gastric corpus (22.0/ under ×400 light microscope) and ileum (26.2/ under ×400 light microscope). 2) Mechanical ileus was associated with significantly higher numbers of Interstitial cells of Cajal when it occurred in the small intestine and ileocecal region than in the large intestine, and the longer the first defecation period (coarctation ileus) the significantly lower number of Interstitial cells of Cajal.