Abstract
In recent years the emphasis in Hirschsprung's disease has been largely directed toward histology and histochemical findings and to the results of the surgical procedures currently practiced. However, in the individual patient with Hirschsprung's disease, of greater significance can be the occurrence of life-threatening enterocolitis. In its most severe form, this is associated with gross dilatation of the colon and profound toxemia, the combination being termed toxic megacolon. Because of its relative rarity and the need for neonatologists and pediatric surgeons to keep in mind this potentially disastrous complication, a patient with toxic megacolon is described and a therapeutic approach suggested.
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Carrico J, Meakinn JL (1986) Multiple organ failure syndrome. Arch Surg 121: 196–208
Ehrenpreis TH (1970) Hirschsprung's disease. Year Book Medical Publishers, Chicago
Imamura A, Puri P, O'Briain DS et al (1992) Mucosal immune defence mechanisms in enterocolitis complicating Hirschsprung's disease. Gut 33: 801–806
Madison MS, Bargan JA (1951) Fulminating ulcerative colitis with unusual segmental dilatation of the colon; report of a case. Mayo Clinic Proc 26: 21–24
Marshak RH, Lester LJ, Friedman AI (1950) Megacolon; a complication of ulcerative colitis. Gastroenterology 16: 768–772
Menardi G (1982) Toxic megacolon. In: Holschneider AM (ed) Hirschsprung's disease. Hippokrates Stuttgart, pp 125–131
Nixon HH (1972) Problems in the diagnosis of Hirschsprung's disease. Paediatr Paedol [Suppl] 2: 23–31
Sieber WK (1986) Hirschsprung's disease. In: Welch KJ, Randolph JG, Ravitch MD, O'Neill JA Jr, Rowe MI (eds) Paediatric surgery, 4th edn, chap. 106. Year Book Medical Publishers, Chicago, London, pp 995–1020
Swenson O (1959) Hirschsprung's disease (aganglionic megacolon). New Engl J Med 260: 972
Tancrede CH, Andremont AO (1985) Bacterial translocation and gram-negative bacteremia in patients with hematological malignancies. J Infest Dis 152: 99–103
Thomas DFM, Fernie DS, Malone M (1982) Association betweenClostridium difficile and enterocolitis in Hirschsprung's disease. Lancet i: 78–89
Thomas DFM, Fernie DS, Bayston L (1986) Enterocolitis in Hirschsprung's disease. A controlled study of etiologic role ofClostridium difficile. J Pediatr Surg 21: 22–25
Thomfors NR, Rybak JJ, Pace WG (1969) Toxic megacolon. Surg Gynecol Obstet 128: 21–26
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Suita, S., Sakaguchi, T., Arima, T. et al. Toxic megacolon in Hirschsprung's disease is still potentially fatal. Pediatr Surg Int 9, 433–435 (1994). https://doi.org/10.1007/BF01686029
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DOI: https://doi.org/10.1007/BF01686029