Skip to main content
PMC home page
Gut logoLink to Gut
. 1986 May;27(5):534–541. doi: 10.1136/gut.27.5.534

Hirschsprung's disease and idiopathic megacolon in adults and adolescents.

P R Barnes, J E Lennard-Jones, P R Hawley, I P Todd
PMCID: PMC1433503  PMID: 3699562

Abstract

The distinction between Hirschsprung's disease and idiopathic megacolon in childhood dates from the classic clinical, radiological, and histological studies of Bodian, Stephens, and Ward. This article describes clinical experience over 15 years of 94 patients in whom megacolon of these two types was recognised for the first time after the age of 10, to illustrate the problems of diagnosis and treatment in later years. Just as it is now recognised that patients with the clinical characteristics of Hirschsprung's disease may have one of several abnormalities of the myenteric plexus, including not only absence of ganglion cells, but also patchy or zonal loss, abnormal neurones or neuronal dysplasia, so idiopathic megacolon may also be a heterogeneous group of cases. This paper suggests on clinical grounds that those patients with idiopathic megacolon whose symptoms start in childhood differ from those whose symptoms develop in later years.

Full text

PDF
534

Images in this article

535Fig. 1
on p.535
535Fig. 2
on p.535
537Fig. 6
on p.537

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaronson I., Nixon H. H. A clinical evaluation of anorectal pressure studies in the diagnosis of Hirschsprung's disease. Gut. 1972 Feb;13(2):138–146. doi: 10.1136/gut.13.2.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. CALLAGHAN R. P., NIXON H. H. MEGARECTUM: PHYSIOLOGICAL OBSERVATIONS. Arch Dis Child. 1964 Apr;39:153–157. doi: 10.1136/adc.39.204.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Emery J. L. Colonic retention syndrome (megacolon) associated with immaturity of intestinal intramural plexus. Proc R Soc Med. 1973 Mar;66(3):222–223. [PMC free article] [PubMed] [Google Scholar]
  4. Faverdin C., Dornic C., Arhan P., Devroede G., Jehannin B., Revillon Y., Pellerin D. Quantitative analysis of anorectal pressures in Hirschsprung's disease. Dis Colon Rectum. 1981 Sep;24(6):422–427. doi: 10.1007/BF02626775. [DOI] [PubMed] [Google Scholar]
  5. Howard E. R., Garrett J. R., Kidd A. Constipation and congenital disorders of the myenteric plexus. J R Soc Med. 1984;77 (Suppl 3):13–19. [PMC free article] [PubMed] [Google Scholar]
  6. MacMahon R. A., Moore C. C., Cussen L. J. Hirschsprung-like syndromes in patients with normal ganglion cells on suction rectal biopsy. J Pediatr Surg. 1981 Dec;16(6):835–839. doi: 10.1016/s0022-3468(81)80829-9. [DOI] [PubMed] [Google Scholar]
  7. McCready R. A., Beart R. W., Jr Adult Hirschsprung's disease: results of surgical treatment at Mayo Clinic. Dis Colon Rectum. 1980 Sep;23(6):401–407. doi: 10.1007/BF02586788. [DOI] [PubMed] [Google Scholar]
  8. Meier-Ruge W. Hirschsprung's disease: its aetiology, pathogenesis and differential diagnosis. Curr Top Pathol. 1974;59:131–179. doi: 10.1007/978-3-642-65857-0_4. [DOI] [PubMed] [Google Scholar]
  9. Nagasaki A., Ikeda K., Suita S., Sumitomo K. Induction of the rectoanal reflex by electric stimulation. A diagnostic aid for Hirschsprung's disease. Dis Colon Rectum. 1984 Sep;27(9):598–601. doi: 10.1007/BF02553850. [DOI] [PubMed] [Google Scholar]
  10. Nixon H. H., Lake B. 'Not Hirschsprung's disease'--rare conditions with some similarities. S Afr J Surg. 1982 Jun;20(2):97–104. [PubMed] [Google Scholar]
  11. Orr J. D., Scobie W. G. Presentation and incidence of Hirschsprung's disease. Br Med J (Clin Res Ed) 1983 Dec 3;287(6406):1671–1671. doi: 10.1136/bmj.287.6406.1671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Patriquin H., Martelli H., Devroede G. Barium enema in chronic constipation: is it meaningful? Gastroenterology. 1978 Oct;75(4):619–622. [PubMed] [Google Scholar]
  13. Preston D. M., Lennard-Jones J. E., Thomas B. M. Towards a radiologic definition of idiopathic megacolon. Gastrointest Radiol. 1985;10(2):167–169. doi: 10.1007/BF01893094. [DOI] [PubMed] [Google Scholar]
  14. Rich A. J., Lennard T. W., Wilsdon J. B. Hirschsprung's disease as a cause of chronic constipation in the elderly. Br Med J (Clin Res Ed) 1983 Dec 10;287(6407):1777–1778. doi: 10.1136/bmj.287.6407.1777. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Smith B., Grace R. H., Todd I. P. Organic constipation in adults. Br J Surg. 1977 May;64(5):313–314. doi: 10.1002/bjs.1800640504. [DOI] [PubMed] [Google Scholar]
  16. Tobon F., Schuster M. M. Megacolon: special diagnostic and therapeutic features. Johns Hopkins Med J. 1974 Aug;135(2):91–105. [PubMed] [Google Scholar]
  17. Todd I. P. Adult Hirschprung's disease. Br J Surg. 1977 May;64(5):311–312. doi: 10.1002/bjs.1800640503. [DOI] [PubMed] [Google Scholar]
  18. Todd I. P. Some aspects of adult megacolon. Proc R Soc Med. 1971 May;64(5):561–565. [PMC free article] [PubMed] [Google Scholar]
  19. Udassin R., Nissan S., Lernau O., Hod G. The mild form of Hirschsprung's disease (short segment): fourteen-years experience in diagnosis and treatment. Ann Surg. 1981 Dec;194(6):767–770. doi: 10.1097/00000658-198112000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES