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Ultrastructural study of the muscle coat of the gastric wall in a case of systemic sclerosis
  1. L Ibba-Manneschi1,
  2. A Del Rosso2,
  3. S Pacini1,
  4. A Tani1,
  5. P Bechi3,
  6. M Matucci Cerinic2
  1. 1Department of Anatomy, Histology and Forensic Medicine, University of Florence, Florence, Italy
  2. 2Department of Internal Medicine, Rheumatology Section, University of Florence
  3. 3Clinical Surgery, University of Florence
  1. Correspondence to:
    Dr L Ibba-Manneschi, Department of Anatomy, Histology and Forensic Medicine, viale Morgagni 85, 50134, Florence, Italy;
    ibba{at}unifi.it

https://doi.org/10.1136/ard.61.8.754

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    In systemic sclerosis (SSc), which affects the microcirculation and leads to fibrosis of skin and internal organs,1 the oesophagus and the colon are the gastrointestinal (GI) segments most commonly affected, even though other tracts can be impaired.2,3

    In SSc, a few ultrastructural examinations of the oesophageal and rectal wall have been made,4,5 but no study has been carried out on the stomach. This prompted us to examine the gastric wall of a patient with SSc by transmission electron microscopy (TEM) in order to investigate the components of the muscle coat.

    CASE REPORT

    In 1997 a 52 year old woman, with limited SSc (lSSc) since 1979, came to our attention. She had Raynaud's phenomenon, sclerodactyly, anticentromere antibodies, and Sjöf-gren's syndrome, but no lung, heart, and kidney disease. From the onset of her SSc, the patient had severe involvement of the distal oesophagus, which was confirmed by oesophagogastroscopy.

    In May 1998 the gastro-oesophageal symptoms worsened despite treatment (ranitidine and, later, omeprazole and cisapride) and the patient underwent a Nissen-Rossetti laparoscopic fundoplication. Eight months later, as she became progressively unable to eat, she underwent a total gastrectomy with a Roux-en-Y oesophagojejunal anastomosis operation.

    Samples of gastric anterior wall near the …

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