Extensive intestinal aganglionosis including the ileum: a new surgical technique.

Extensive aganglionosis including the ileum occurs in less than 5% of children with Hirschsprung's disease; in these cases nutrition, fluid, and electrolyte balance are a problem. The author reports an infant with extensive aganglionosis including the ileum in whom an endorectal pull-through of the Soave type as modified by Boley was performed with a longitudinal side-to-side anastomosis between the aganglionic and normal intestine, preserving terminal ileum and ileocecal valve. At two and one-half years of age the infant is well. He is toilet trained and has 1 to 4 soft bowel movements per day as he is in the 50th percentile for weight. When extensive aganglionosis involves the small intestine, saving the important function of the terminal ileum and the ileocecal valve is possible and highly desirable.