Diagnosis of congenital megacolon in children What are the symptoms of congenital megacolon in children

Measuring the reflex pressure changes of the rectum and anal sphincter can diagnose congenital megacolon and identify constipation caused by other reasons. In normal children and those with functional constipation, when the rectum is stimulated by expansion, the internal sphincter immediately relaxes reflexively and the pressure drops. In children with congenital megacolon, the internal sphincter not only does not relax, but also contracts significantly, causing the pressure to increase. This method can sometimes produce false positive results in newborns under 10 days old.

Hirschsprung's disease in children is caused by continuous spasm of the rectum or the intestinal tube at the distal end of the colon, which causes feces to accumulate in the proximal colon. This is a congenital disease. Once you find your symptoms, you should seek timely treatment. This disease is best treated when you are a child, which is conducive to treatment. The following editor will introduce the diagnosis and treatment of this disease.

diagnosis

1. Medical history and physical signs

More than 90% of the children have no meconium within 36 to 48 hours after birth, and then have intractable constipation and abdominal distension, and have a history of defecation only after enema, laxatives or anal plugs. They often have malnutrition, anemia and loss of appetite. The abdomen is highly distended and wide intestinal type can be seen. Rectal digital examination feels that the rectal ampulla is empty and no feces can be touched. Feces can only be touched beyond the spasmodic segment to the dilated segment.

2. X-ray findings

Abdominal upright plain films often show low colon obstruction. Barium enema lateral and anteroposterior photos show typical spasmodic and dilated intestinal segments, poor barium excretion function, and barium is still retained after 24 hours. If the barium is not washed out by enema in time, barium stones may form. When combined with enteritis, the dilated intestinal wall appears serrated. In the neonatal period, dilated intestinal tubes can only be seen by comparison half a month after birth. If the diagnosis is still not confirmed, the following examinations are performed.

3. Biopsy

Take a small piece of tissue from the submucosal layer and muscular layer of the rectal wall more than 4 cm away from the anus to check the number of ganglion cells. Children with megacolon lack ganglion cells.

4. Anorectal manometry

Measuring the reflex pressure changes of the rectum and anal sphincter can diagnose congenital megacolon and identify constipation caused by other reasons. In normal children and those with functional constipation, when the rectum is stimulated by expansion, the internal sphincter immediately relaxes reflexively and the pressure drops. In children with congenital megacolon, the internal sphincter not only does not relax, but also contracts significantly, causing the pressure to increase. This method can sometimes produce false positive results in newborns under 10 days old.

5. Rectal mucosal histochemical examination

This is based on the fact that the proliferating and hypertrophic parasympathetic preganglionic fibers in the submucosal and muscular ganglion cell-deficient areas of the spasmodic segment continuously release large amounts of acetylcholine and cholinesterase. Chemical methods can determine that the amount and activity of both are 5 to 6 times higher than that of normal children, which is helpful for the diagnosis of congenital megacolon and can be used for newborns.

Neonatal congenital megacolon should be differentiated from intestinal obstruction caused by other reasons, such as low small bowel atresia, colon atresia, meconium constipation, and neonatal peritonitis.

Older infants and children should be differentiated from secondary megacolon caused by rectal and anal stenosis, compression of tumors inside and outside the lumen, colon weakness (such as constipation caused by children with hypothyroidism), habitual constipation, and idiopathic megacolon in children (which usually occurs suddenly after the age of 2 and is caused by internal sphincter dysfunction, and is mainly treated with comprehensive and conservative treatment).

When complicated with enterocolitis, it should be differentiated from viral, bacterial enteritis or septic intestinal paralysis.

The above is what I want to introduce to you about the diagnosis and treatment of congenital megacolon in children. This is a congenital disease. There are many causes of this disease, but what we can generally do is to do a good job of health care during pregnancy and strengthen the care of pregnant women. Finally, I wish you all good health and a speedy recovery.