J.Jpn. Surg. Soc.. 57(10): 1713-1727, 1957

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HISTOPATHOLOGIC STUDY ON THE EXPERIMENTALLY INDUCED STENOSIS OF THE ESOPHAGUS

The author has made a series of histopathologic study on the development of the experimental esophageal stenosis in 51 dogs. For the histologic examination, three portions of different levels were selected, i.e., 1) immediately above, 2) distantly above, and 3) immediately below the experimental stenosis. In addition to the routine histologic examination, the Nissl's staining method was employed for the specific study of the Auerbach's plexus. The pathologic alteration occurred, more or less, in all of the three layers of the esophageal wall where a stenosis was previously made. However, the proliferative change prevails immediately above the stricture which, in the muscular layer tends to develop into hypertrophy as the stenosis persists. Directly below the stenosis, on the other hand, the characteristic feature is of atrophic change which becomes more conspicuous as the experimental days proceed. The lesions of the Auerbach's nereve cells is relatively slight up to from 14th to 23rd experimental day. On 45th day, however, a marked degeneration develops which is more conspicuous at the portion immediately above the stenosis. In the initial stage of the stricture, 10th, 14th and 23rd exper imental days, the change of the plexus is dependent on the degree of the dilatation of the esophageal wall directly above the stenosis. The Auerbach's plexus in the esophageal wall was specially observed employing a modified Bielschowsky-Gros's staining method. The level difference of the pathological changes of this particular plexus may be emphasized : the portion immediately above the stenosis being most severely involved. The changes become more prominent as the stenotic process remains longer. In the initial stage of the stenosis (on 10th, 14th, 23rd experimental days) the histologic alteration of the plexus proved to be greater in a case where the dilatation above the stenosis was conspicuous. But in an advanced stage of the stenosis , the degeneration of the plexus become more remarkable regardless of the development of the dilatation. The involvement of the nerve fibers in the degenerative process in a chronic stenosis seems to suggest, in connection with the fact that the degeneration of the nervous cells occurs simultaneously in the esophageal wall, that the Auerbach's plexus may be the place of the primary lesion. In an experimental stage when the esophageal wall above the stenosis shows an abnormal motility, the fine histologic change of the Auerbach's plexus is well demonstrable.
From the results of the experimentally induced stanosis of the esophageal wall, it may be tentatively concluded that the Auerbach's plexus has the poorest adaptive capacity among the esophageal structures.
(author's abstract)

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