Increased submucosal nerve trunk caliber in aganglionosis: a "positive" and objective finding in suction biopsies and segmental resections in Hirschsprung's disease.

摘要: Objective To establish the diagnostic usefulness of submucosal hypertrophic nerve trunk morphology in Hirschsprung's disease as a quantifiable parameter supportive aganglionosis on hematoxylin-eosin-stained sections. Design We retrospectively evaluated size and density nerves sections S100 protein-stained resected segments from 13 patients with disease, 20 aganglionic 50 ganglionic rectal suction biopsies. Setting All were seen at Childrens Hospital Los Angeles (Calif), tertiary-care pediatric center; age diagnosis or resection ranged between 2 days 3 years. Results Aganglionic contain many distinct trunks greater than 40 microm diameter. Ganglionic segments/biopsies showed no larger this threshold value (P approximately .0000). Nerve such caliber are rarely encountered pathologic transition zones sites colostomy. Conclusions Submucosal that diameter strongly correlate abnormal innervation/aganglionosis. Use objective evaluating biopsies should be helpful morphologic infancy early childhood.