Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Sep;21(3):362-6.

Hirschsprung's Disease: a Clinical and Pathologic Study in Iranian Constipated Children

Maryam Monajemzadeh  1 , Mehdi Kalantari, Bahareh Yaghmai, Roya Shekarchi, Fatemeh Mahjoub, Mehrzad Mehdizadeh
Affiliations

Hirschsprung's Disease: a Clinical and Pathologic Study in Iranian Constipated Children

Maryam Monajemzadeh et al. Iran J Pediatr. 2011 Sep.

Abstract

Objective: Hirschsprung's disease (HD) is a complex disorder resulting from absence of ganglion cells in the bowel wall leading to functional obstruction and bowel dilatation proximal to the affected segment. The aim of our study was to evaluate rectal biopsies from constipated children in different age groups to see in which age it is more likely to encounter HD to avoid unnecessary rectal biopsy.

Methods: Records of all children with chronic constipation undergoing a rectal biopsy to exclude HD were obtained from the files of Children's Medical Center in Tehran, Iran. A detailed retrospective demographic review, including age of beginning of signs and symptoms was made of all cases.

Findings: Totally, 172 biopsies were taken from 168 children in a five year period, of which 127 cases (75%) had HD. The mean age of constipated patients at biopsy was 39 months and the mean age of patients with proven HD was 18 months. Males were affected more than females. Congenital anomalies associated with HD were found in 9.6%. In 85 (91%) cases constipation had begun in neonatal period.

Conclusion: Our data supports previous studies that if constipation begins after the neonatal period, the child is unlikely to have HD. In neonates delay in meconium passage is the most important clinical sign of HD.

Keywords: Biopsy; Constipation; Functional Gastrointestinal Disorders; Hirschsprung's Disease; Intestinal Obstruction.

PubMed Disclaimer

References

    1. Croffie JM, Davis MM, Faught PR, et al. At what age is a suction rectal biopsy less likely to provide adequate tissue for identification of ganglion cells? J Pediatr Gastroenterol Nutr. 2007;44(2):198–202. - PubMed
    1. Barshack I, Fridman E, Goldberg I, et al. The loss of calretinin expression indicates aganglionosis in Hirschsprung's disease. J Clin Pathol. 2004;57(7):712–6. - PMC - PubMed
    1. Amiel J, Sproat-Emison E, Garcia-Barcelo M, et al. Hirschsprung Disease Consortium. Hirschsprung disease associated syndromes and genetics: a review. J Med Genet. 2008;45(1):1–14. - PubMed
    1. Lewis NA, Levitt MA, Zallen GS. Diagnosing Hirschsprung's disease: increasing the odds of a positive rectal biopsy result. J Pediatr Surg. 2003;38(3):412–6. discussion 412-6. - PubMed
    1. Alizai NK, Batcup G, Dixon MF, Stringer MD. Rectal biopsy for Hirschsprung's disease: what is the optimum method? Pediatr Surg Int. 1998;13(2-3):121–4. - PubMed

LinkOut - more resources