Clinical Observation of Congenital Megacolon

Chung, Young Jin; Liegh, Woo Gill; Lee, Ki Young; Chin, Dong Shik; Han, WoonSub

Journal of the Korean Pediatric Society 1975;18(1):40-46.
Published online January 31, 1975.

Clinical Observation of Congenital Megacolon

Young Jin Chung¹, Woo Gill Liegh¹, Ki Young Lee¹, Dong Shik Chin¹, WoonSub Han²

¹Department of Pediatrics, Yonsei University, College of Medicine
²Department of Pathology, Yonsei University, College of Medicine, Korea.

선천성 거대 결장증에 대한 임상적 관찰

정영진^¹^, 이우길^¹^, 이기영^¹^, 진동식^¹^, 한운섭^²

^¹연세대학교 의과대학 소아과학교실
^²연세대학교 의과대학 병리학교실

Abstract

Congenital Megacolon is due to congenital defect of the parasympathetic ganglionic cells in Auerbach’s plexus causing constriction anatomically at rectum or rectosigmoid in majority and an abscence of peristalsis and propulsive movement functionally with marked dilatation at the proximal bowel of the defected area. We have experienced 33 caess of congenital megacolon from January, 1957 to December, 1972 and this disease is still regarded as an interesting challengable subject especially to Pediatrician, and Pediatric Surgeon. And the retrospective detailed review of 33 cases was undertaken at Pediatric department of Yon-sei Medical Center. We have got following results: 1.Most of cases was male, which was 93. 9%. 2.The age differences of symptomatic onset; under 1 week was 60. 6%，between 1 and 4 weeks 21.3%,between 1 and 6 months 3%, between 6 and 12 months in 3%. This revealed that most cases had initial symptom before the age of 4 weeks. 3.The symptoms and signs were abdominal distension(84. 8%), constipation(66. 7%), vomiting (33.3%) and no meconium passing (18.2%). These are symptoms and signs of intestinal obstruction. 4.The character of stool in most of cases (90.9%) was hard formed but loose or watery stool was noticed in 9.1%. 5.The durations between colostomy and onset cf the symptom were 1 to 4 weeks in 33. 3%, over 1 year in 18.2%, 1 to 3 months in 15.2%, under 1 week in 12% and 3 to 6 months in. 6.1%. 6.The sites of intestinal constriction was noticed at rectosigmoid colon in 42.4%, sigmoid in 27. 3%, rectum in 1.2% and descending or entire colon in 10%. And so most of cases (69. 7%) had the upper end of constriction at sigmoid colon. 7.In most of cases (80%) the body weight were under 10 percentill by the time they had the colostomy. 8. As radical operation, DuhameFs method was taken in 70.6% and Swenson’s method 29.4%. Durations between primary colostomy and repairment were 1 and 2 years in 35. 3%, 2 and 3 years in 29.4% and then 3 and 4 years in 17.6%. 9.Death before or after operation occurred in 5 cases; 4 cases due to peritonitis and 1 case due to pneumonia.