3 research outputs found
Hirschsprung's Disease: a Clinical and Pathologic Study in Iranian Constipated Children
Objective: Hirschsprung's disease (HD) is a complex disorder resulting
from absence of ganglion cells in the bowel wall leading to functional
obstruction and bowel dilatation proximal to the affected segment. The
aim of our study was to evaluate rectal biopsies from constipated
children in different age groups to see in which age it is more likely
to encounter HD to avoid unnecessary rectal biopsy. Methods: Records of
all children with chronic constipation undergoing a rectal biopsy to
exclude HD were obtained from the files of Children's Medical Center in
Tehran, Iran. A detailed retrospective demographic review, including
age of beginning of signs and symptoms was made of all cases. Findings:
Totally, 172 biopsies were taken from 168 children in a five year
period, of which 127 cases (75%) had HD. The mean age of constipated
patients at biopsy was 39 months and the mean age of patients with
proven HD was 18 months. Males were affected more than females.
Congenital anomalies associated with HD were found in 9.6%. In 85 (91%)
cases constipation had begun in neonatal period. Conclusion: Our data
supports previous studies that if constipation begins after the
neonatal period, the child is unlikely to have HD. In neonates delay in
meconium passage is the most important clinical sign of HD