Journal of Pediatric Surgery
Volume 31, Issue 4 , Pages 490-497, April 1996

The ontogeny of the peptide innervation of the human pylorus, with special reference to understanding the aetiology and pathogenesis of infantile hypertrophic pyloric stenosis

  • Robin Michael Abel

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Mr Robin Michael Abel, Department of Surgery, Birmingham Children's Hospital, NHS Trust, Ladywood Middleway, Birmingham B16 8ET, England.
    • Mr Robin Abel was the Research Fellow at the Institute of Child Health, London, England.

London England

Abstract 

Pyoric stenosis (PS) is a common condition in infancy, which is associated with smooth muscle hypertrophy that results in pyloric outlet obstruction. The author examines the ontogeny of the peptide innervation of the pylorus in fetal tissues and an experimental model in mice and evaluates the histochemical and morphological changes in the pylorus. The data suggest that PS is an intrauterine lesion that occurs by 12 weeks' gestation. This is associated with diminished nitric oxide in human tissues and reduced enzyme activity (resulting from a deficiency in an enzyme cofactor) in mice. Increased vasoactive intestinal polypeptide expression in pyloric myenteric ganglia may be an intrinsic mechanism for resolving this condition.

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 Presented at the 42nd Annual International Congress of the British Association of Paediatric Surgeons, Sheffield, England, July 25–28, 1995.

 This essay was the prize-winning award for the BAPS Trainees Prize. Mr Abel's supervisors were Professor L. Spitz (Institute of Child Health, London) and Professor J.M. Polak (The Royal Postgraduate Medical School, London).

PII: S0022-3468(96)90481-9

Journal of Pediatric Surgery
Volume 31, Issue 4 , Pages 490-497, April 1996

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