Lassmann G, Wurnig P
Wien Klin Wochenschr. 1980 Jun;92(12):420-33.
This study is based on a collection of 385 cases of constipation in newborn infants and young children, investigated clinically and by means of histological and neurohistological examination of biopsies taken from the rectal mucosa. Neurohistological techniques proved superior for the differential diagnosis and, hence, of greater value for determining further therapeutic management, both medical and surcival. Four special problems are discussed: Hirschsprung's disease in different neurohistological and clinical findings in these cases, functional ileus of the large intestine in newborn infants, chronic constipation and, lastly, the problems of anal stenosis and anal atresia. The present series of cases serves to illustrate that colostomy, carried out at the right time, can be a life-saving procedure in coping with the grave problem of a potentially lethal enterocolithis in constipation of different aetiology of the newborn or somewhat older infant. Neurohistological investigation is, however, essential for verification of the diagnosis because in Hirschsprung's disease emergency colostomy prevents the development of megacolon.
本研究基于对385例新生儿和幼儿便秘病例的收集，通过临床检查以及对取自直肠黏膜的活检组织进行组织学和神经组织学检查。神经组织学技术在鉴别诊断方面被证明更具优势，因此对于确定进一步的治疗管理（包括药物治疗和手术治疗）具有更大价值。讨论了四个特殊问题：这些病例中不同神经组织学和临床发现的先天性巨结肠、新生儿大肠功能性肠梗阻、慢性便秘，以及最后肛门狭窄和肛门闭锁问题。本系列病例表明，在适当的时候进行结肠造口术，可以作为应对新生儿或稍大婴儿不同病因便秘中潜在致命性小肠结肠炎这一严重问题的救命手术。然而，神经组织学检查对于确诊至关重要，因为在先天性巨结肠中，紧急结肠造口术可防止巨结肠的发展。
