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Clinical impact of intestinal neuronal malformatio

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

General Surgery

Advisors

Qaddah, Nabhan T. , El-Feqi, Muhammad A. Fayed, Yahya

Authors

Yasin, Tamer Yasin Muhammad

Accessioned

2017-07-12 06:41:43

Available

2017-07-12 06:41:43

type

M.D. Thesis

Abstract

Hirschsprung’s disease is the congenital absence of parasympathetic innervations to the distal intestine. This occurs once in every 5000 live births with a 4: 1 male to female predominance; 96% are term and 4% premature babies. Symptoms usually begin at birth with delayed passage of meconium. Initial evaluation includes an unprepped barium enema. The aganglionic rectum appears of normal caliber or spastic, there is a transition zone and then dilated colon proximal to the aganglionic segment. Rectal suction biopsy is then performed and the submucosal plexus is examined for ganglion cells. Allied Hirschsprung’s disorders (AHDs) are a group of motility disorders that mimic Hirschsprung’s disease such as hypoganglionosis (HYPG), zonal aganglionosis, immature ganglia (IMG), neuronal intestinal dysplasia (NID) and chronic idiopathic intestinal pseudoobstruction (CIIP). Giant ganglia reduced parasympathetic tone, immature ganglia, and hypo genetic or heterotopic nerve cells are other forms of malformations. This study was conducted at the department of pediatric surgery at Cairo University Pediatric Hospital (CUPH) during the period from June 1998 till April 2001. This study included fifty cases of chronic constipation in infants and children with ages between 4 months and 5 years. All the results were correlated with the outcome of surgery and postoperative symptomatology. At follow-up 6 months to 1.5 years after the initial therapy, most of the patients who underwent resection of an aganglionic bowel segment had normal bowel movements and were free of symptoms. In patients without aganglionosis, only one third had normal bowel movements postoperatively, significantly less than those with total aganglionosis. At follow-up, half of them had constipation and one patient had overflow encopresis. These symptoms were successfully managed by conservative treatment.

Issued

1 Jan 2002

DOI

http://dx.doi.org/10.21473/iknito-space/37046

Details

Type

Thesis

Created At

28 Jan 2023