ID 110795
Author
Takehara, Hiroo Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School
Ishibashi, Hiroki Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Yoshikawa, Kouzo Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Shimada, Mitsuo Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
Hirschsprung’s disease
intestinal neuronal dysplasia (IND)
HaIND acetylcholinesterase
constipation
endorectal pull-through operation
Content Type
Journal Article
Description
Between 1996 and 2002, 22 cases of Hirschsprung’s disease were treated laparoscopically by endorectal pull-through operation. The proximal margin of the resected bowel materials from these 22 patients were examined histologically by frozen sections at surgery and also after surgery using HampE staining, and complete resection of the aganglionic segment was confirmed. Eleven patients, in whom an informed consent was obtained at randomly, underwent suction biopsy from the pulled-though neorectum after surgery. Of these 11 patients, 2 revealed many AchE-positive nerve fibers in the lamina propria, the muscularis mucosa and around the ganglion cells in the submucosal plexuses. These structural changes were similar to intestinal neuronal dysplasia that was characterized by hyperganglionosis and other neuronal abnormalities. The remaining 9 revealed no AchE activity. Unexpectedly, the two patients showing AchE activity in their neorectum continued to have persistent constipation and were treated with laxatives or glycerin enema. It was suggested that their persistent constipation was caused by intestinal neuronal dysplasia showing an abnormal increase of AchE activity in spite of presence of ganglion cells of the neorectum after surgery, but it was uncertain that they were primary condition as a HaIND or secondary reactions after surgery.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Volume
53
Issue
1-2
Start Page
113
End Page
116
Sort Key
113
Published Date
2006-02
FullText File
language
eng
TextVersion
Publisher
departments
Medical Sciences
University Hospital