A FURTHER DESCRIPTION OF THE PATHOLOGIC PHYSIOLOGY OF CONGENITAL MEGACOLON AND THE RESULTS OF SURGICAL TREATMENT

[摘要] Follow-up results of a series of patients with congenital megacolon operated upon between the years 1947 and 1955 are presented. The operative procedure was complete removal of the rectum and lower sigmoid with replacement by more proximal colon and a sigmoido-anal anastomosis.A discussion of the problem of anal continence in normal children as well as children upon whom a "pull through" procedure has been done has been presented.This study revealed that 50% of patients who have had pull through procedures became completely continent within 1 year, 34% became continent within 5 years, and 16% have some residual difficulty with bowel control. Analysis of the reasons for imperfect anal control reveals that enterocolitis and psychologic maladjustment are two prominent features.It is concluded that the replacement of the rectum and lower sigmoid by proximal colon in congenital megacolon has proven successful as manifested by long-term follow-up study.

[学科分类] 儿科学