Hirschsprung disease (dilated large intestine)

Abdomen | Gastroenterology | Hirschsprung disease (dilated large intestine) (Disease)


Description

Hirschsprungs disease, also known as congenital megacolon or aganglionic megacolon, is an abnormality in which certain nerve fibers are absent in segments of the bowel, resulting in severe bowel obstruction.

Causes and Risk factors

Hirschsprungs disease is caused when certain nerve cells (called parasympathetic ganglion cells) in the wall of the large intestine (colon) do not develop before birth. Without these nerves, the affected segment of the colon lacks the ability to relax and move bowel contents along. This causes a constriction and as a result, the bowel above the constricted area dilates due to stool becoming trapped, producing megacolon (dilation of the colon). The disease can affect varying lengths of bowel segment, most often involving the region around the rectum. In up to 10% of children, however, the entire colon and part of the small intestine are involved.

Hirschprungs disease occurs once in every 5,000 live births, and it is about four times more common in males than females. Between 4% and 50% of siblings are also afflicted. The wide range for recurrence is due to the fact that the recurrence risk depends on the gender of the affected individual in the family (i. e. if a female is affected, the recurrence risk is higher) and the length of the aganglionic segment of the colon (i. e. the longer the segment that is affected, the higher the recurrence risk).

Diagnosis and Treatment

Children who have Hirschsprungs disease require surgery to remove the area of the large intestine that has no nerve cells. Sometimes a baby will need enemas to remove stool from the intestine until surgery can be performed. ...