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Fetal Pediatr Pathol. 2013 Dec;32(6):422-8. doi: 10.3109/15513815.2013.799248. Epub 2013 Jun 6.

Noniatrogenic neonatal gastric perforation: the role of interstitial cells of Cajal.

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1Pathology, Childrens Hospital of Atlanta -Egleston, Emory University School of Medicine, Atlanta, Georgia, USA.


Noniatrogenic neonatal gastric perforation is a rare and life-threatening condition whose etiology is often unclear. Interstitial cells of Cajal act as gastrointestinal pacemaker cells and express the proto-oncogene c-Kit. Six new cases were identified at our institution which presented with no mechanical, pharmacologic, or otherwise medical-related intervention prior to rupture. The number of interstitial cells of Cajal in nonnecrotic muscularis propria from five random high-power fields per specimen was compared using immunohistochemical stains for c-Kit. The authors show that a lack of interstitial cells of Cajal in the stomach musculature may be implicated in the development of noniatrogenic gastric perforation (p = 0.008). Further large-scale studies, including molecular and genetic analysis, may help to better understand this phenomenon.

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