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KMID : 0378019770200050103
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New Medical Journal
1977 Volume.20 No. 5 p.103 ~ p.111
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Radiologic Evaluation of Congenital Megacolon
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Abstract
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The pathogenesis of Hirschsprung´s disease or Congenital Megacolon is an absence of ganglion cells of myenteric plexus in a segment of bowel. It has its onset in the newborn. The presenting signs and symptoms can be easily mistaken for mechanical obstruction in critically ill neonate. Definite radiological diagnosis is possible in the vast majority of cases in infancy. But it is difficult in neonate.
This report presents a retrospective detailed review of presenting signs, symptoms and radiologic findings of 26 patients who had diagnosed as Congenital Megacolon at Severance Hospital by operation and pathology. The results are;
1. In 26 cases of Hirschsprung´s disease are 25 males and only one female.
2. Onset of symptoms and signs appear within 1 week after birth in 73%.
3. Abdominal distention, constipation, dehydration and vomiting are the common symptoms and signs.
4. 79% of patients responding passed their first meconium after the first 24 hours of life.
5. In simple abdominal film, moderate and marked gaseous distention of small and large bowel, are noted in all cases. But multiple air fluid level are only in 12%. In 42%, specific diagnosis of Congenital Megacolon were obtained with only simple abdominal film, especially lateral view.
6. The most important pathognomic roentgen sign of Barium Enema is zone of transition. And others are irregular bizarre contraction of aganglionic segment, barium retention following a. barium enema study and parallel transverse folds in dilatated proximal colon.
7. Almost 96% of the patients had aganglinosis limited to the rectum and sigmoid colon. And which were identical with Barium Enema study finding.
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