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ABSTRACT. A double balloon technique was used for anal tonometry in 22 infants. The weight was less than 2500 g in 10 of the infants. Ileus or delayed passage of meconium was seen in 9 infants. Thirteen infants had not revealed any symptoms of intestinal obstruction during the first week of life. In all cases, except one, it was possible to demonstrate reflexes from the internal anal sphincter. In 18 infants normal curves were registered from the internal anal sphincter. None of these developed Hirschsprung's disease. In 3 infants a pathological pattern of contractions of the internal anal sphincter was demonstrated. Two of them proved to have Hirschsprung's disease. In the third case normal reflexes were registered after one year. Possibly the innervation of rectum and the internal anal sphincter was disrupted during the neonatal period in connection with enterocolitis and ileus, thus representing a reversible case of achalasia. 相似文献
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手术治疗小儿先天性巨结肠42例,其中Duhamel术9例,Swenson术11例,Soave术6例,Rehbein术10例,直肠后壁肌切除4例,直肠肛管纵切心形斜吻合术2例。术后污粪、便秘、小肠结肠炎及肛门狭窄发生率21%。认为:手术疗效是与术前充分准备,选择适宜术式,术中精细操作,术后加强护理,精心喂养等直接相关 相似文献
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Kazuo Imai Takuya Maeda Yusuke Sayama Kei Mikita Yuji Fujikura Kazuhisa Misawa Morichika Nagumo Osamu Iwata Takeshi Ono Ichiro Kurane Yasushi Miyahira Akihiko Kawana Sachio Miura 《Emerging infectious diseases》2014,20(1):146-148
We report a patient with congenital Chagas disease in Japan. This report reemphasizes the role of neglected and emerging tropical diseases in the era of globalization. It also indicates the need for increased vigilance for detecting Chagas disease in non–disease-endemic countries. 相似文献
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目的 探讨先天性巨结肠及其同源病定义、病理诊断方法及标准.方法 记录2015年10月在武汉同济医院小儿外科召开的先天性巨结肠(Hirschsprung's disease,HD)及其同源病临床与病理国际高峰论坛峰会病理分会中的热点问题及展开的深入讨论,并进行归纳总结.结果 直肠黏膜活检AchE染色被一致认可为术前诊断的金标准.巨结肠切除术中活检是必需的,但染色方法的选择未有统一.作为传统方法,单纯HE染色的精确性受到了质疑,普遍认为需要同时进行其他染色,而具体染色方法因各自习惯而异.目前缺乏大样本的正常新生儿和儿童肠道发育各项数据,因此对于神经节细胞减少症,神经元发育不良的诊断标准尚有争论.肠神经元发育不良(intestinal neuro-nal dysplasia,IND)是不是一种疾病实体,是原发性还是继发性疾病未有定论.病理发现的各类非神经节病变目前还不清楚应该如何定义和归类,因此更要求病理专家应对其作出详尽描述.结论 国内外对巨结肠及其同源病在定义、病理诊断方法及标准上有一定共识,但部分争论热点由于缺乏理论和实践数据支撑而未有统一结论,而这些热点必将成为将来研究的新方向. 相似文献
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Background
After surgery for Hirschsprung's disease (HD) the majority of patients have satisfactory clinical outcomes. Nevertheless, a substantial number of patients remain who suffer from severe persistent constipation. Current consensus attributes these complaints to the hallmarks of HD. In non-HD patients a cause for severe constipation is dyssynergic defecation.Methods
Retrospectively, we reviewed the medical records of ten postoperative HD patients with severe persistent constipation who had undergone extensive anorectal function tests to diagnose the reason for the constipation. We analyzed the results of these tests.Results
During the last three years, ten postoperative HD patients with severe persistent constipation were given extensive anorectal function tests. All ten patients were diagnosed with dyssynergic defecation. The ages at the time of diagnosis ranged from 7 to 19 years with a median age of 12 years. Signs of an enlarged rectum were seen in all ten patients, with a maximum measured value of 845 mL.Conclusions
Patients with HD may also suffer from dyssynergic defecation. It is important to consider this possibility when dealing with severe persistent constipation in postoperative HD patients. Viable options for treating dyssynergic defecation are available that could prevent irreversible long-term complications. 相似文献10.
Leukocytapheresis (LCAP) for Management of Fulminant Ulcerative Colitis with Toxic Megacolon 总被引:4,自引:0,他引:4
Sawada K Egashira A Ohnishi K Fukunaga K Kusaka T Shimoyama T 《Digestive diseases and sciences》2005,50(4):767-773
Leukocytapheresis (LCAP) is a method of therapeutic apheresis to remove patients peripheral leukocytes by extracorporeal circulation. Previous studies showed that LCAP for the treatment of ulcerative colitis (UC) was more effective and had fewer adverse effects compared to high-dose steroid therapy. However, there are no reports on the application of LCAP for UC patients with toxic megacolon (TM). This study reports the effectiveness and safety of LCAP in treating patients with severe or fulminant UC with TM. Six patients were enrolled in this study and LCAP sessions were performed three times per week for 2 weeks, followed by four further times in the next 4 weeks. After completion of therapy, four patients improved in TM and went into the remission stage of UC. The average Rachmilewitz clinical activity index of these four patients improved from 19.5 to 1. The remaining two patients had to undergo colectomy, however, the symptoms had been mitigated by LCAP and the operations were completed without any problems. These results suggest that LCAP is an additional effective and safe option for TM management in preventing colectomy or for bridging to a safer operation. 相似文献