Nervous structure of Meckel's diverticulum in children

Vol. 53 No. 3 Suppl., 2012
This supplement was not sponsored by Outside Organizations.


V. Negrea, D. Gheban

Meckel's diverticulum, being considered as the most frequent malformation of the digestive tract, has been largely presented in scientific papers, but a complete physiopathological mechanism for its natural history has not been yet described. We have studied the nervous system and the differences observed in eight Meckel's diverticulums with enteric or ectopic gastric mucosa, using specific immunohistochemical markers. It has been noted a significantly higher density of myenteric nerve fibers in areas with enteric mucosa compared with the areas with gastric heterotopias, while the transition zone had intermediate nerve fibers density. The ileal wall near the diverticulum had a myenteric plexus density similar to gastric mucosa intradiverticular area. The density of Meckel's diverticulum myenteric plexuses determines the local peristalsis. The enteric type mucosa diverticulums has more intense peristaltic activity which leads more frequent to intussusception or, in case of intraluminal obstruction, might be also involved in germ spreading and progression of infectious process. The lower density of Auerbach's plexus nerve fibers in cases with gastric heterotopia Meckel's diverticulum determines less effective drainage of diverticular content, favoring the contact of intradiverticular mucosa with acid secretion of gastric mucosa area. The gastric mucosa's defense mechanisms and the intense peristaltic activity in the zone with enteric mucosa offer a certain protection against the apparition of intradiverticular ulcerative lesions, which usually are observed on the ileum, near the diverticulum. The age related decreasing number of myenteric nerve fibers density explains the higher frequency of Meckel's diverticulum complications in children.

Corresponding author: Voicu Negrea, MD; e-mail:

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Raluca Oana Temneanu, A. Motoc, F. E. Zugun, Roxana Folescu, Catalina Elena Lupusoru, Carmen Lacramioara Zamfir

The light-dark cycle represents a significant component of the circadian system in most mammals. Any disturbance of this cycle is reflected in a large number of changes in the physiological and also behavioral status of the organism, together with considerable alterations of the redox balance. Increasing evidence suggests that reactive oxygen species (ROS) have their own function in the circadian system. Superoxide dismutases (SOD) family represents the first prompt antioxidant enzymatic system, identified in all aerobic organisms and able to counteract ROS toxicity; there are three distinct isoenzymes: CuZn-SOD (SOD1), Mn-SOD (SOD2), and extracellular EC-SOD (SOD3). In the case of circadian disruption, when ROS production is enhanced, the impact of the oxidative aggression on superoxide dismutases (SOD) rhythmicity and distribution is still unclear. To estimate the influence of circadian rhythms disruption on pulmonary SOD, we exposed male Wistar rats to continuous light stimuli for four weeks and then investigated the SOD immunohistochemical expression in lungs, which are among the most sensitive organs to oxygen. CuZn-SOD, Mn-SOD and EC-SOD presented a particular immunoreactivity in the investigated pulmonary tissues. These findings support our viewpoint that there is a direct correlation between the rhythmicity of circadian cycles and pulmonary SOD expression.

Corresponding author: Carmen Lacramioara Zamfir, Professor, MD, PhD; e-mail:

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