Megacolon and Microcolon

Abstract

Pediatricians express difference of opinion as to the relative frequency of megacolon. Some authors of wide experience are able to make reports on only one or two such cases; that such experience is not general is attested by the fact that in the literature of the past four years there are more than one hundred papers each of which deals with one to six cases. It follows, therefore, that the affliction cannot be extremely rare. We have encountered six cases during the past five years; two of these passed from observation after one view and, therefore, are not included in this report. Microcolon, on the other hand, seems to be truly an unusual condition, as our search through the literature revealed but three certain and one doubtful case, although it seems probable that some reports under the caption "Stenosis of the Colon" may have referred to this condition. The name "megacolon" has been used to describe the clinical picture characterized by obstinate constipation, great abdominal enlargement, visible intestinal peristalsis with the constitutional results of toxemia due to fecal retention. Constipation at times causes such retention of feces that fecal masses accumulate; these may shift and cause attacks of acute or subacute obstruction of the bowel. The literature referring to this congenital enlargement of the colon is ample. In his masterly article written in 1908, Finney presents a bibliography of 206 titles compiled by A. W. Fisher, complete to the time of his writing. We have searched the libraries diligently and find that over 100 papers on the subject have appeared since Finney's writing. One of the best of these later articles was written by Barrington-Ward and published in January, 1914. One must agree with Barrington-Ward's statement that Finney's paper so completely discusses all phases of the disease that it must remain the authoritative communication on this subject for a long time to come. Although Finney shows that some twenty odd cases, one by Lewitt of Chicago (1867) and another by Jacobi, were clearly described before Hirschsprung published his studies of the malady in 1896, we owe the eminent Dane a debt for centering attention on the importance of the condition. This writer classified giant colon as: (a) true mega¬ colon, first noticeable at birth or early infancy; (b) pseudomegacolon, making its first appearance in adult life and showing dilatation of the

Interstitial cells of Cajal in the normal gut and in intestinal motility disorders of childhood

“…It has also been reported that symptoms have a progressive development with worsening of constipation and a diagnosis made after the first year of life or in rare cases in adolescence or adulthood [111][112][113][114][115].…”