Celayir Ayşenur, Çetiner Handan, Ağartan Canan Aldırmaz, Günaydın Reyhan, Celayir Arın
Department of Pediatric Surgery, Istanbul Zeynep Kamil Maternity and Children's Diseases Health Training and Research Center, University of Health Sciences, Istanbul, Turkey.
Department of Pathology, Istanbul Zeynep Kamil Women and Children's Diseases Health Training and Research Center, University of Health Sciences, Istanbul, Turkey.
Pediatr Surg Int. 2025 May 30;41(1):153. doi: 10.1007/s00383-025-06003-z.
In 1886, Harald Hirschsprung presented what he believed to be a new and rare condition at the Berlin Congress for Children's Diseases. In 1888, still unaware of earlier reports, he published a paper titled "Constipation in Newborns as a Consequence of Dilation and Hypertrophy of the Colon," suggesting that the enlargement of the colon was congenital. Although he noted a narrowing of the rectum in his initial case, Hirschsprung attributed this condition to a dilated intestine rather than a narrowed rectum. In fact, F. Ruysch had described a case of over-enlarged colon as early as 1691, and in 1800, D. Battini published another case of severe constipation posthumously. Between 1825 and 1888, around 20 similar cases had been documented in medical literature. K. Tittel was the first person to draw attention to the narrow rectum and the absence or scarcity of ganglion cells in this region in 1901. However, he did not identify this as the exact cause of the disease, This was evident not only in his own article but also in references to his work in other publications. Despite this fact in the literature, the disease is known as "Hirschsprung Disease". Given the historical and scientific context, it may be time to reconsider the attribution of K. Tittel's discovery and to recognize the significant contributions of him in understanding of this disease.
1886年,哈拉尔德· Hirschsprung在柏林儿童疾病大会上提出了他认为是一种新的罕见病症。1888年,他仍未意识到早期的报告,发表了一篇题为《新生儿便秘是结肠扩张和肥大的后果》的论文,认为结肠的增大是先天性的。尽管他在最初的病例中注意到直肠变窄,但Hirschsprung将这种情况归因于扩张的肠道而非变窄的直肠。事实上,早在1691年,F. Ruysch就描述过一例结肠过度增大的病例,1800年,D. Battini死后发表了另一例严重便秘的病例。在1825年至1888年期间,医学文献中记录了大约20例类似病例。1901年,K. Tittel是第一个注意到直肠变窄以及该区域神经节细胞缺失或稀少的人。然而,他并未将此确定为该病的确切病因,这不仅在他自己的文章中很明显,在其他出版物中提及他的工作时也很明显。尽管文献中有这一事实,但这种疾病仍被称为“先天性巨结肠症”。鉴于历史和科学背景,或许是时候重新考虑对K. Tittel发现的归因,并认可他在理解这种疾病方面所做出的重大贡献了。