Congenital Megacolon is due to congenital defect of the parasympathetic ganglionic cells in Auerbach´s plexus causing constriction anatomically at rectum or rectosigmoid in majority and s an abscence of peristalsis and propulsive movement functionally with marked dilatation at the proximal bowel of the defected area.
We have experienced 33 cases of congenital megacolon from January, 1957 to December, 1972 and this disease is still regarded as an interesting challengable subject especially to Pediatrician and Pediatric Surgeon.
And the retrospective detailed review of 33 cases was undertaken at Pediatric department of Yonsei Medical Center.
We have got following results:
1. Most of cases was male, which was 93.9%.
2. The age differences of symptomatic onset; under 1 week was 60.6%, between 1 and 4 weeks 21.3%, between 1 and 6 months 3%, between 6 and 12 months in 3%. This revealed that most cases had initial symptom before the age of 4 weeks.
3. The symptoms and signs were abdominal distensicn(84.8%), constipation(66.7%), vomiting (33.3%) and no meconium passing (18.2%). Thcse are symptoms and signs of intestinal obstruction.
4. The character of stool inmost of cases (90.9%) was hard formed but loose or watery stool was noticed in 9. 1%
5. The durations between colostomy znd onset cf the symptom were 1 to 4 weeks in 33.3%, over 1 year in 18.2%, 1 to 3 months in 15.2%, under 1 week in 12% and 3 to 6 months in 6. 1%.
6. The sites of intestinal constriction was noticed at rectosigmoid colon in 42.496, sigmoid in 27.3%, rectum in 1.2% and descending or entire colon in 10%. And so most of cases (69.7%) had the upper end of constriction at sigmoid colon.
7. In most of cases (80%) the body weight were under 10 percentill by the time they had the colostomy.
8. As radical operation, Duhamel´s method was taken in 70.6% and Swenson´s method 29.4%. Durations between primary colostomy and repairment were 1 and 2 years in 35.3%, 2 and 3 years in 29.4% and then 3 and 4 years in 17.6%.
9. Death before or after operation occurred in 5 cases; 4 cases due to peritonitis and 1 case due to pneumonia.
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