Abstract

The authors report 18 cases of idiopathic megacolon,15 ale,and female,aged from 4.5 to 12 years.The chief complaint in all Chronic cases was constipation. Roentgeuographic examination by barium enema showed a dilated rectum in all.The rectal dilatation ratio (redtal' transverse diameter divided by pelvic transverse diameter on frontal XR) was 81.5%,remarkably greater than the normal contrel group (45%,p＜0.01).At anorectal manometry,all cases showed a positive anal relaxation reflex. The resting pressure of both external and internal sphincters did not show statistical difference from that of normal children (p＞0.05).But the minimum quantity of air needed to provoke the relaxation reflex was greater than normal control group(40 to 70 ml.).Six cases had an relaxation wave of a hook-form.Besides,in 7 cases the base line of the internal sphincter decreased progressively,suggesting the etiology of the idiopathic megacolon a functional disturbance of the interhal sphincter.12 of the 18 cases were treated by combined methods:repeated orced anal dilatations,enemas and acupuncture Excellent results were obtained in 7 and amelioration in 5,which are better than simple purgative medication.

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