{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T19:42:10Z","timestamp":1764790930608,"version":"3.46.0"},"reference-count":25,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context.\u2014<\/jats:title>\n                    <jats:p>Colonic inertia is a debilitating form of primary chronic constipation with unknown etiology and diagnostic criteria, often requiring pancolectomy. We have occasionally observed massively enlarged submucosal ganglia containing at least 20 perikarya, in addition to previously described giant ganglia with greater than 8 perikarya, in cases of colonic inertia. These massively enlarged ganglia have yet to be formally recognized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective.\u2014<\/jats:title>\n                    <jats:p>To determine whether such \u201cmassive submucosal ganglia,\u201d defined as ganglia harboring at least 20 perikarya, characterize colonic inertia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design.\u2014<\/jats:title>\n                    <jats:p>We retrospectively reviewed specimens from colectomies of patients with colonic inertia and compared the prevalence of massive submucosal ganglia occurring in this setting to the prevalence of massive submucosal ganglia occurring in a set of control specimens from patients lacking chronic constipation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.\u2014<\/jats:title>\n                    <jats:p>Seven of 8 specimens affected by colonic inertia harbored 1 to 4 massive ganglia, for a total of 11 massive ganglia. One specimen lacked massive ganglia but had limited sampling and nearly massive ganglia. Massive ganglia occupied both superficial and deep submucosal plexus. The patient with 4 massive ganglia also had 1 mitotically active giant ganglion. Only 1 massive ganglion occupied the entire set of 10 specimens from patients lacking chronic constipation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.\u2014<\/jats:title>\n                    <jats:p>We performed the first, albeit distinctly small, study of massive submucosal ganglia and showed that massive ganglia may be linked to colonic inertia. Further, larger studies are necessary to determine whether massive ganglia are pathogenetic or secondary phenomena, and whether massive ganglia or mitotically active ganglia distinguish colonic inertia from other types of chronic constipation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5858\/arpa.2016-0551-oa","type":"journal-article","created":{"date-parts":[[2017,10,5]],"date-time":"2017-10-05T14:49:49Z","timestamp":1507214989000},"page":"208-212","source":"Crossref","is-referenced-by-count":2,"title":["Massive Submucosal Ganglia in Colonic Inertia"],"prefix":"10.5858","volume":"142","author":[{"given":"Kaveh","family":"Naemi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Stamos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark Li-cheng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","published-online":{"date-parts":[[2017,10,5]]},"reference":[{"issue":"5","key":"2020081219481270000_i1543-2165-142-2-208-b01","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1038\/nrgastro.2016.53","article-title":"Diagnosis and management of chronic constipation in adults","volume":"13","author":"Rao","year":"2016","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"8","key":"2020081219481270000_i1543-2165-142-2-208-b02","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1007\/s10620-015-3754-1","article-title":"Understanding the pathogenesis of slow-transit constipation: one step forward","volume":"60","author":"Wang","year":"2015","journal-title":"Dig Dis Sci"},{"issue":"5","key":"2020081219481270000_i1543-2165-142-2-208-b03","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/PAI.0b013e31827387c9","article-title":"Smoothelin expression in the gastrointestinal tract: implication in colonic inertia","volume":"21","author":"Chan","year":"2013","journal-title":"Appl Immunohistochem Mol Morphol"},{"issue":"5","key":"2020081219481270000_i1543-2165-142-2-208-b04","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1097\/PAS.0b013e31819b381a","article-title":"The role of immunohistochemistry in idiopathic chronic intestinal pseudoobstruction (CIPO): a case-control study","volume":"33","author":"Amiot","year":"2009","journal-title":"Am J Surg Pathol"},{"issue":"2","key":"2020081219481270000_i1543-2165-142-2-208-b05","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s004280050141","article-title":"Are giant ganglia a reliable marker of intestinal neuronal dysplasia type B (IND B)?","volume":"432","author":"Lumb","year":"1998","journal-title":"Virchows Arch"},{"issue":"7","key":"2020081219481270000_i1543-2165-142-2-208-b06","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1097\/00042737-200012070-00007","article-title":"Dysplasia of the submucous nerve plexus in slow-transit constipation of adults","volume":"12","author":"Voderholzer","year":"2000","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"5","key":"2020081219481270000_i1543-2165-142-2-208-b07","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1055\/s-2008-1066121","article-title":"Experience with neuronal intestinal dysplasia (NID) in adults","volume":"4","author":"Stoss","year":"1994","journal-title":"Eur J Pediatr Surg"},{"issue":"1","key":"2020081219481270000_i1543-2165-142-2-208-b08","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s10350-004-6114-3","article-title":"Oligoneuronal hypoganglionosis in patients with idiopathic slow-transit constipation","volume":"45","author":"Wedel","year":"2001","journal-title":"Dis Colon Rectum"},{"issue":"3","key":"2020081219481270000_i1543-2165-142-2-208-b09","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/00000478-199403000-00004","article-title":"Ganglioneuromas of the gastrointestinal tract: relation to Von Recklinghausen disease and other multiple tumor syndromes","volume":"18","author":"Shekitka","year":"1994","journal-title":"Am J Surg Pathol"},{"issue":"6","key":"2020081219481270000_i1543-2165-142-2-208-b10","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1055\/s-2004-821120","article-title":"Updated results on intestinal neuronal dysplasia (IND B)","volume":"14","author":"Meier-Ruge","year":"2004","journal-title":"Eur J Pediatr Surg"},{"issue":"2","key":"2020081219481270000_i1543-2165-142-2-208-b11","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1309\/PY6JMKHXDGN0F3DK","article-title":"Colorectal intramucosal perikarya of ganglion cells","volume":"124","author":"Tunru-Dinh","year":"2005","journal-title":"Am J Clin Pathol"},{"issue":"1","key":"2020081219481270000_i1543-2165-142-2-208-b12","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1177\/1066896906295955","article-title":"Intramucosal ganglion cells in normal adult colorectal mucosa","volume":"15","author":"Tunru-Dinh","year":"2007","journal-title":"Int J Surg Pathol"},{"issue":"2","key":"2020081219481270000_i1543-2165-142-2-208-b13","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00418-009-0657-2","article-title":"Two submucosal nerve plexus in human intestines","volume":"133","author":"Brehmer","year":"2010","journal-title":"Histochem Cell Biol"},{"issue":"1","key":"2020081219481270000_i1543-2165-142-2-208-b14","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/j.1365-2036.2011.04684.x","article-title":"Colonic mast cells in controls and slow transit constipation patients","volume":"34","author":"Bassotti","year":"2011","journal-title":"Aliment Pharmacol Ther"},{"issue":"8","key":"2020081219481270000_i1543-2165-142-2-208-b15","doi-asserted-by":"crossref","first-page":"2304","DOI":"10.1007\/s10620-015-3612-1","article-title":"The relationship between colonic macrophages and microRNA-128 in the pathogenesis of slow transit constipation","volume":"60","author":"Liu","year":"2015","journal-title":"Dig Dis Sci"},{"issue":"5","key":"2020081219481270000_i1543-2165-142-2-208-b16","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1046\/j.1365-2982.2000.00221.x","article-title":"Increased mast cells in the irritable bowel syndrome","volume":"12","author":"O'Sullivan","year":"2000","journal-title":"Neurogastroenterol Motil"},{"issue":"7","key":"2020081219481270000_i1543-2165-142-2-208-b17","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1053\/gast.2002.33579","article-title":"Activation of the mucosal immune system in irritable bowel syndrome","volume":"122","author":"Chadwick","year":"2002","journal-title":"Gastroenterology"},{"issue":"7","key":"2020081219481270000_i1543-2165-142-2-208-b18","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1111\/j.1365-2982.2006.00781.x","article-title":"Novel smooth muscle markers reveal abnormalities of the intestinal musculature in severe colorectal motility disorders","volume":"18","author":"Wedel","year":"2006","journal-title":"Neurogastroenterol Motil"},{"issue":"1","key":"2020081219481270000_i1543-2165-142-2-208-b19","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/S0016-5085(00)70409-4","article-title":"Decreased interstitial cell of Cajal volume in patients with slow-transit constipation","volume":"118","author":"He","year":"2000","journal-title":"Gastroenterology"},{"issue":"12","key":"2020081219481270000_i1543-2165-142-2-208-b20","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1053\/jpsu.2000.19228","article-title":"Rectal mucosal biopsy compared with laparoscopic seromuscular biopsy in the diagnosis of intestinal neuronal dysplasia in children with slow-transit constipation","volume":"35","author":"Imaji","year":"2000","journal-title":"J Pediatr Surg"},{"issue":"7","key":"2020081219481270000_i1543-2165-142-2-208-b21","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1097\/01.meg.0000224476.51428.7b","article-title":"Intestinal neuronal dysplasia","volume":"18","author":"Sk\u00e1ba","year":"2006","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"5","key":"2020081219481270000_i1543-2165-142-2-208-b22","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1080\/15384101.2015.1004937","article-title":"Neuronal cell cycle: the neuron itself and its circumstances","volume":"14","author":"Frade","year":"2015","journal-title":"Cell Cycle"},{"issue":"2","key":"2020081219481270000_i1543-2165-142-2-208-b23","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.ydbio.2016.04.001","article-title":"White paper on guidelines concerning enteric nervous system stem cell therapy for enteric neuropathies","volume":"417","author":"Burns","year":"2016","journal-title":"Dev Biol"},{"issue":"1","key":"2020081219481270000_i1543-2165-142-2-208-b24","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1002\/stem.557","article-title":"Prospective identification and isolation of enteric nervous system progenitors using Sox2","volume":"29","author":"Heanue","year":"2011","journal-title":"Stem Cells"},{"issue":"3","key":"2020081219481270000_i1543-2165-142-2-208-b25","doi-asserted-by":"crossref","first-page":"397","DOI":"10.4292\/wjgpt.v7.i3.397","article-title":"Intestinal neuronal dysplasia type B: a still little known diagnosis for organic causes of intestinal chronic constipation","volume":"7","author":"Toledo de Arruda Louren\u00e7\u00e3o PL, Terra SA, Ortolan EV, Rodrigues MA","year":"2016","journal-title":"World J Gastrointest Pharmacol Ther"}],"container-title":["Archives of Pathology &amp; Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/142\/2\/208\/1447527\/arpa_2016-0551-oa.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/142\/2\/208\/1447527\/arpa_2016-0551-oa.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T19:34:44Z","timestamp":1764790484000},"score":1,"resource":{"primary":{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/142\/2\/article-p208.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,5]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,10,5]]},"published-print":{"date-parts":[[2018,2,1]]}},"URL":"https:\/\/doi.org\/10.5858\/arpa.2016-0551-oa","relation":{},"ISSN":["0003-9985","1543-2165"],"issn-type":[{"type":"print","value":"0003-9985"},{"type":"electronic","value":"1543-2165"}],"subject":[],"published":{"date-parts":[[2017,10,5]]}}}