Zur klinischen Bedeutung der neuronalen intestinalen Dysplasie

Abstract

Neuronal intestinal dysplasia is histologically and histochemically well defined. The resection of the neuronal dysplastic segment is usually recommended in the literature as being curative. Whether a resection is necessary in every case remains to be debated. The case history of a male patient with Hirschsprung's disease and proximal intestinal neuronal dysplasia of the entire colon is presented. After manometrical, radiological and functional examination the aganglionic portion of the gut only has been resected and the neuronal dysplastic part has been left in situ. Several months later the patient is well. It seems possible to avoid in some selected cases a subtotal or total colectomy.

Neuronal Intestinal Dysplasia - Clinical and Histochemical Findings and Its Association with Hirschsprung's Disease

“…Die Kombination beider Läsionen führte zu einer Überlagerung der Symptome, so daß eine Differenzierung in eine akute, früh beginnende Gruppe Ader NID (mit Hypoplasie des Sympathikus) und eine chronische, spät beginnende Gruppe B (mit regelrechter sympathischer Innervation) nur morphologisch, jedoch nicht klinisch möglich war. 5 der 16 Patienten mit NID hatten schwere Mißbildungen; 2 davon zeigten eine Trisomie 21.…”

Relationships between Myers-Briggs Type Indicator (MBTI) Psychological Type and Marital Satisfaction, Divorce Proneness, Positive Affect, and Conflict Regulation in Clinic Couples

“…33,34,[188][189][190][191][192][193] Many types of operative interventions have been used that include total or partial resection of the affected bowel, 183,189,191,[194][195][196] the IND-affected bowel untouched, [197][198][199][200][201] resection of the aganglionic segment with partial resection of the IND-affected bowel, 33,185,191,202 sphinctermyectomy, 191,198 and the creation of short-and long-term colostomies. 33,34,[188][189][190][191][192][193] Many types of operative interventions have been used that include total or partial resection of the affected bowel, 183,189,191,[194][195][196] the IND-affected bowel untouched, [197][198][199][200][201] resection of the aganglionic segment with partial resection of the IND-affected bowel, 33,185,191,202 sphinctermyectomy, 191,198 and the creation of short-and long-term colostomies.…”

“…34,35,[184][185][186][187]189,193,196,[198][199][200][201][203][204][205] In addition, several authors believe that patients can have spontaneous resolution of symptoms. Symptoms are disparate from 1 report to another, and there is a wide range in the severity and presence of symptoms (such as diarrhea, constipation, vomiting, and distension).…”

Colonic inertia disorders in pediatrics

“…Patients with IND have been subjected to several types of treatment, including medical treatment with laxatives, enemas, and total parenteral nutrition. 33,34,[188][189][190][191][192][193] Many types of operative interventions have been used that include total or partial resection of the affected bowel, 183,189,191,[194][195][196] resection of a coexistent aganglionic segment, leaving the IND-affected bowel untouched, [197][198][199][200][201] resection of the aganglionic segment with partial resection of the IND-affected bowel, 33,185,191,202 sphinctermyectomy, 191,198 and the creation of short-and long-term colostomies. 184,187,189,198 Once again, specific descriptions of what was resected anatomically, how extensive was the IND, and follow-up results are absent from these reports.…”

“…The most significant problem is no consistent topographic description; therefore, the proposed treatments cannot be correlated with a specific anatomic diagnosis. 34,35,[184][185][186][187]189,193,196,[198][199][200][201][203][204][205] In addition, several authors believe that patients can have spontaneous resolution of symptoms. 162,189,192,198 These patients must have some definable pathophysiologic state that we simply have not identified yet.…”