W Cheng, AE Bishop, L Spitz, JM Polak

Aims: Oesophageal dysmotility is common in children suffering from oesophageal atresia (OA). Enteric nerve abnormality has been suspected as one of causes. Neuronal morphology was studied in the atretic oesophagus of fetal rats with adriamycin induced oesophageal atresia.

Methods: The fetal rats were divided into 4 groups: 1) normal control, 2) normal saline injected group, 3) adriamycin injected but without development of OA and 4) adriamycin injected with development of OA. The distal segments of the atretic oesophagus were immuno-stained with a general neuronal marker, protein gene product 9.5 (PGP). Immunoreativity per cross-sectional area was calculated with an image-analyzer. The extent of the oesophageal circumference covered by the PGP stained nerve tissue was assessed.

Results:

While there was no significant difference in PGP immunoreactivity per cross-sectional area between the groups, the near complete ring of nerve tissue around the normal oesophageal circumference was replaced by clusters of nerve tissue in the atretic group (normal vs OA group, p=0.001, Mann-Whitney U test) (Table).

Conclusions: The abnormal distribution of nerve tissue in the atretic oesophagus may be a contributing factor in oesophageal dysmotility.