Myenteric plexitis: A frequent feature in patients undergoing surgery for colonic diverticular disease

Abstract
Background: Diverticular disease of the colon is frequent in clinical practice, and a large number of patients each year
undergo surgical procedures worldwide for their symptoms. Thus, there is a need for better knowledge of the basic
pathophysiologic mechanisms of this disease entity.
Objectives: Because patients with colonic diverticular disease have been shown to display abnormalities of the enteric
nervous system, we assessed the frequency of myenteric plexitis (i.e. the infiltration of myenteric ganglions by inflammatory
cells) in patients undergoing surgery for this condition.
Methods: We analyzed archival resection samples from the proximal resection margins of 165 patients undergoing left
hemicolectomy (60 emergency and 105 elective surgeries) for colonic diverticulitis, by histology and immunochemistry.
Results: Overall, plexitis was present in almost 40% of patients. It was subdivided into an eosinophilic (48%) and a lymphocytic
(52%) subtype. Plexitis was more frequent in younger patients; and it was more frequent in those undergoing emergency
surgery (50%), compared to elective (28%) surgery (p ¼ 0.007). All the severe cases of plexitis displayed the lymphocytic subtype.
Conclusions: In conclusion, myenteric plexitis is frequent in patients with colonic diverticular disease needing surgery, and
it might be implicated in the pathogenesis of the disease.