Aganglionic Segment Of Bowel Research Articles

Electrophysiological and Pharmacological Studies on Innervation of the Aganglionic Bowel Segment

Electrophysiological and Pharmacological Studies on Innervation of the Aganglionic Bowel Segment

Hirschsprung's disease : William L. Schey and Harvey White. Amer. J. Roentgen. 112,1:105–115 (May) 1971

T HE classic roentgenographic features of Hirschsprung’s disease have been well documented.5 They include narrowing and spasm of the aganglionic distal segment of bowel in continuity with more dilated proximal, normally innervated bowel. Classic findings are not always present, especially in the neonate.8”3 Some roentgenographic features in the difficult cases may exist, however, which either reflect underlying Hirschsprung’s disease, or mask or mimic it. Seven cases are reported, all of which were considered to possibly have Hirschsprung’s disease. The details of the histories, roentgenographic findings and confirmed diagnoses are discussed. It is the purpose of this paper to present case material which demonstrates some problems leading to difficulty in making or excluding the diagnosis of Hirschsprung’s (disease.

Fluid and serum electrolyte disturbances as a complication of enemas in Hirschsprung's disease.

HIRSCHSPRUNG'S disease, or intestinal aganglionosis, is generally characterized by abdominal distention with constipation secondary to a functional colonic obstruction; an aganglionic segment of bowel usually in the rectosigmoid area lacks coordinated propulsive contractions. Anatomically, the aganglionic portion is narrowed and the proximal colon is dilated and hypertrophied. Several complications are known to result from the compromised ability to evacuate colonic contents: intestinal obstruction, enterocolitis, spontaneous rupture of the colon, anemia, hypoproteinemia and edema, and retarded growth. 1 Enemas to facilitate colonic evacuation are recommended treatment for this disease. However, because the enema may be retained and because a large surface area is available for absorption, tap-water enemas are known to produce water intoxication, and their use is not recommended. Recently the use of other types of enemas has been suggested, among them hypertonic phosphate enemas. 1 Our experience with four children in whom two additional complications of enemas, hypernatremic dehydration

Sympathetic innervation of the colon in Hirschsprung's disease: A histochemical study

Rectosigmoidectomy specimens from 10 patients with Hirschsprung's disease were studied histochemically by a fluorescence technic, permitting selective visualization of adrenergic nerve terminals. In histologically normal segments of bowel, synaptic arborizations around the intrinsic ganglia were present and had the same appearance as demonstrated earlier in several animal species. In aganglionic bowel, no adrenergic synapses were found. These findings imply that the mediation of not only parasympathetic but also sympathetic influences to aganglionic bowel is interrupted. Functional denervation promotes spastic contraction, which is the main characteristic of the distal aganglionic segment of bowel in Hirschsprung's disease.

Hirschsprung's disease: New surgical treatment

1. 1. Diagnosis and treatment of sixty-nine patients with Hirschsprung's disease have been reported. 2. 2. The basic pathology has been shown to lie an aganglionic segment of distal large bowel which, lacking peristalsis, obstructs the normal evacuation of feces and gas. 3. 3. The type of resection employed in correcting this obstruction in sixty-nine cases is described, with satisfactory results in sixtyseven.