Functional Colonic Ultrasonography: Normal Findings of Colonic Motility and Follow-Up in Neuronal Intestinal Dysplasia

Pistor, G.

doi:10.1007/978-3-642-74493-8_17

Cited by 10 publications

(10 citation statements)

References 6 publications

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“…Nevertheless, these colostomies all functioned well. The adequate function of these colostomies may represent passive emptying of the colon, and does not prove sucient contractility of the remaining colon to pass stools through the aganglionic sphincter and remaining rectum after pull-through, however [19,20].…”

Section: Discussionmentioning

confidence: 98%

Hirschsprung's disease and intestinal neuronal dysplasia - a frequent association with implications for the postoperative course

Schmittenbecher

Sacher

Cholewa

et al. 1999

Pediatric Surgery International

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Between 1991 and 1993, 106 newly diagnosed cases of Hirschsprung's disease (HD) were prospectively analyzed for the association of HD and intestinal neuronal dysplasia (IND) at ten pediatric surgical departments in central Europe. Hirschsprung-associated IND (HaIND) was found in 40% of cases. IND was disseminated in one-third and localized in two-thirds of the patients. Initial clinical symptoms were related to the length of the aganglionic segment, but not to the presence of HaIND. An enterostomy performed in 72 cases (67.9%) was located in a segment of pathologically innervated bowel in 50% of all cases, but in 72% of cases of HaIND. The proximal margin of the resected bowel showed pathological innervation in 44% of cases. Supplemental biopsies from the intestine (apart from diagnostic suction biopsies and biopsies at the enterostomy site) led to the first identification or definition of length of associated IND in 17.9% of cases. Postoperatively, the presence of long-segment aganglionosis or associated IND implied a delay in the restoration or normal defecation. Persistent constipation was found in 40% of patients with associated disseminated IND at follow-up at 6 months, compared to 20.6% in patients with isolated HD. These children needed secondary interventions more often than patients with associated localized IND or isolated HD. HaIND thus has clinical implications for the postoperative course if IND is disseminated.

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Section: Discussionmentioning

confidence: 98%

Hirschsprung's disease and intestinal neuronal dysplasia - a frequent association with implications for the postoperative course

Schmittenbecher

Sacher

Cholewa

et al. 1999

Pediatric Surgery International

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“…As in Hirschsprung's disease [22], many children with IND B lack a recto-anal reflex [26,27,53]. All these symptoms can disappear, if the vegetative nervous system of the gut matures [46,47,50,53,54]. In almost 95% of young children with IND B gut motility normalizes in the first year of life [9,53,54].…”

Section: Discussionmentioning

confidence: 99%

“…It is a rare disease comprising less than 2% of all dysganglionoses [32,34,55]. IND B, characterized by abnormalities in the development of the submucosal plexus, is almost as frequent as Hirschsprung's disease [34] and has been the subject of many studies [5,10,15,40,46,47,48,49,56,57,58,59,60].…”

Section: Introductionmentioning

confidence: 99%

Histopathological criteria for intestinal neuronal dysplasia of the submucosal plexus (type B)

Meier‐Ruge

Brönnimann

Gambazzi

et al. 1995

Vichows Archiv A Pathol Anat

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The aim of this study was to review critically the diagnostic features of intestinal neuronal dysplasia type B (IND B). Over a period of 5 years colonic mucosal biopsies of 773 children with symptoms of chronic constipation were examined. Four biopsies taken 2-10 cm above the pectinate line were cut in serial sections and histochemical lactate dehydrogenase, succinate dehydrogenase, (SDH) and acetylcholinesterase (AChE) reactions performed. Presence of giant ganglia of the submucosal plexus, being characterized by more than seven nerve cells, established the diagnosis of IND B. Giant ganglia were found to be age-independent changes, while hyperplasia of the submucosal plexus, increase of AChE activity in nerve fibres of the lamina propria and low SDH activity in nerve cells proved to be age-dependent findings which disappear during the maturation of the enteric nervous system. Using these criteria IND B was diagnosed in 209 children. In 64 of these patients a combination of IND B and aganglionosis (Hirschsprung's disease) was found. IND B seems to be related to premature expression of laminin A during embryogenesis, resulting in premature nerve cell differentiation in the myenteric and submucosal plexus, which in turn blocks neuroblast colonization of the rectum. IND B, hypoganglionosis and aganglionosis, which are often combined, may therefore be considered to be different manifestations of the same developmental abnormality.

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“…Radio-opaque markers have traditionally been used to measure gut transit time [15,16], but the use of ultrasound for visualising intestinal motility for diagnostic purposes is gaining acceptance in paediatric practice [17], and also in adults [18]. Paracetamol absorption is a reliable index of gastric emptying of liquid and has been described in ITU patients as a test of gastric motility [7].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Effect of epidural blockade on indicators of splanchnic perfusion and gut function in critically ill patients with peritonitis: a randomised comparison of epidural bupivacaine with systemic morphine

et al. 2000

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Functional Colonic Ultrasonography: Normal Findings of Colonic Motility and Follow-Up in Neuronal Intestinal Dysplasia

Cited by 10 publications

References 6 publications

Hirschsprung's disease and intestinal neuronal dysplasia - a frequent association with implications for the postoperative course

Hirschsprung's disease and intestinal neuronal dysplasia - a frequent association with implications for the postoperative course

Histopathological criteria for intestinal neuronal dysplasia of the submucosal plexus (type B)

Effect of epidural blockade on indicators of splanchnic perfusion and gut function in critically ill patients with peritonitis: a randomised comparison of epidural bupivacaine with systemic morphine

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