| ID | 408 |
|---|---|
| Name | HIRSCHSPRUNG’S DISEASE (Congenital Megacolon) |
| Cause | |
| Signs Symptoms | |
| Diagnosis | Diagnosis: A. Radiography- the objective is to demonstrate the contracted aganglionic segment. B. Biopsy of the ano-rectal wall- absence of ganglion cells in the submucosa & intermuscular nerve plexuses- is the only conclusive means of diagnosis. |
| Investigations | |
| Management | Management: Surgery is the definite measure. Surgical management consists of excising the aganglionic segment and pulling the ganglionic intestine down through the anus anastomosing it to the anal canal within 2.5 cm of the pectinate line. |
| Introduction | This is the most common cause of neonatal obstruction of the colon and accounts for about 33% of all neonatal obstructions. This disease is characterised by enormous dilatation and hypertrophy of the pelvic colon, sometimes extending into the descending colon. The mucosa is chronically inflam-med and frequently ulcerated. There is a terminal constricted, non hypertrophied segment of bowel usually involving the anal canal, rectum and a variable part of the large intestine which is devoid of ganglionic cells. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: 1 . Chronic constipation. 2. There is often failure to thrive. 3. Abdominal distension, vomiting may appear during the 1 st week. 4. Diarrhoea may be a prominent symptom in the neonatal period and be associated with symptoms of intestinal obstruction. 5. Hypoproteinemia and edema may result from protein losing enteropathy. |
| Preventions | |
| Treatment | |
| Complications | |
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| Observation | |
| Pathology |
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