{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:26:00Z","timestamp":1772173560749,"version":"3.50.1"},"reference-count":33,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[1997,3,10]]},"published-print":{"date-parts":[[1997,8,1]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014The aetiology and pathology of both idiopathic megarectum and idiopathic megacolon are unknown. In particular, it is unknown whether there are abnormalities involving enteric nerves or smooth muscle.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods<\/jats:italic>\n                    \u2014Resected tissue was examined from 24 patients who underwent surgery for idiopathic megarectum, from six patients who had tissue resected for idiopathic megacolon, and 17 control patients who had surgery for non-obstructing large bowel cancer. Qualitative and quantitative histological examination was performed after staining with haematoxylin and eosin, periodic acid Schiff (PAS), Martius scarlet blue (MSB), and phosphotungstic acid haematoxylin (PTAH). Neural and glial tissue were examined after immunostaining with S100 and PGP9.5.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    \u2014Compared with controls, patients with idiopathic megarectum had significant thickening of their muscularis mucosae (median 78\n                    <jats:italic>v<\/jats:italic>\n                    33\u2009\u03bcm, p&lt;0.005), circular muscle (1000\n                    <jats:italic>v<\/jats:italic>\n                    633 \u03bcm, p&lt;0.005), and longitudinal muscle (1083\n                    <jats:italic>v<\/jats:italic>\n                    303 \u03bcm, p&lt;0.005), despite rectal dilatation. This thickening was relatively greater in the longitudinal than in the circular muscle. Fibrosis of the longitudinal muscle was seen, using MSB staining, in 58%, of circular muscle in 38%, and of muscularis mucosae in 29% of patients. The relation between muscle thickening and fibrosis was variable. The density of neural tissue in the longitudinal muscle seemed to be reduced in patients with idiopathic megarectum. There was no thickening of enteric muscle or alteration in the density of innervation in patients with idiopathic megacolon.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    \u2014There is notable thickening of the enteric smooth muscle in patients with idiopathic megarectum, but the architecture of the enteric innervation seems to be intact. Functional abnormalities of the latter remain a possible cause of the smooth muscle hypertrophy.\n                  <\/jats:p>","DOI":"10.1136\/gut.41.2.252","type":"journal-article","created":{"date-parts":[[2010,6,30]],"date-time":"2010-06-30T12:46:12Z","timestamp":1277901972000},"page":"252-257","source":"Crossref","is-referenced-by-count":56,"title":["Pathology of idiopathic megarectum and megacolon"],"prefix":"10.1136","volume":"41","author":[{"given":"J M","family":"Gattuso","sequence":"first","affiliation":[{"name":"St Mark\u2019s Hospital, London"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M A","family":"Kamm","sequence":"additional","affiliation":[{"name":"St Mark\u2019s Hospital, London"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I C","family":"Talbot","sequence":"additional","affiliation":[{"name":"St Mark\u2019s Hospital, London"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1997,8,1]]},"reference":[{"key":"2025121312442816000_41.2.252.1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01893094"},{"key":"2025121312442816000_41.2.252.2","first-page":"280","article-title":"Investigation and management of megarectum and megacolon.","volume":"19","author":"Kamm","year":"1993","journal-title":"Hospital Update"},{"key":"2025121312442816000_41.2.252.3","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1002\/bjs.1800780803","article-title":"Management of idiopathic megarectum and megacolon.","volume":"78","author":"Kamm","year":"1991","journal-title":"Br J Surg"},{"key":"2025121312442816000_41.2.252.4","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/0016-5085(87)90926-7","article-title":"Pathology of neuromuscular disorders of the small intestine and colon.","volume":"93","author":"Krishnamurthy","year":"1987","journal-title":"Gastroenterology"},{"key":"2025121312442816000_41.2.252.5","unstructured":"Milla PJ Smith VV (1994) Aganglionosis, hypoganglionosis and hyperganglionosis: clinical presentation and histopathology. in Constipation. eds Kamm MA Lennard-Jones JE (Wrightson Biomedical Publishing, Petersfield), pp 183\u2013192."},{"key":"2025121312442816000_41.2.252.6","unstructured":"Smith VV Lake BD (1994) Pathology of intestinal pseudo-obstruction. in Constipation. eds Kamm MA Lennard-Jones JE (Wrightson Biomedical Publishing, Petersfield), pp 241\u2013250."},{"key":"2025121312442816000_41.2.252.7","first-page":"150","article-title":"Histological investigations into \u201cidiopathic megacolon\u201d.","volume":"41","author":"Duhamel","year":"1966","journal-title":"Arch Dis Child"},{"key":"2025121312442816000_41.2.252.8","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1966.01330040084015"},{"key":"2025121312442816000_41.2.252.9","first-page":"15","article-title":"Atonic megacolon.","volume":"10","author":"Palmer","year":"1967","journal-title":"Can J Surg"},{"key":"2025121312442816000_41.2.252.10","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(71)90854-2"},{"key":"2025121312442816000_41.2.252.11","doi-asserted-by":"publisher","DOI":"10.1136\/gut.27.5.534"},{"key":"2025121312442816000_41.2.252.12","first-page":"605","article-title":"Idiopathic megacolon presenting with fatal inferior vena caval obstruction and colonic perforation.","volume":"154","author":"Scott","year":"1988","journal-title":"Acta Chir Scand"},{"key":"2025121312442816000_41.2.252.13","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050671"},{"key":"2025121312442816000_41.2.252.14","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1002\/bjs.1800530312","article-title":"Megacolon in adults.","volume":"53","author":"Kune","year":"1966","journal-title":"Br J Surg"},{"key":"2025121312442816000_41.2.252.15","unstructured":"Morson BC Dawson IMP Day DW Jass JR Price AB Williams GT , eds (1990) Morson and Dawson\u2019s Gastrointestinal pathology. 3rd edn. 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