Hirschsprung's disease pathological and histochemical studies

Sixteen colorectal specimens were used to study the innervation of the normal bowel and that of Hirschsprung's disease. Ten of them were resected from patients having established disease and 6 were normal postmortem specimens. Both groups were studied by macro and micro-dissection and parts were used for histological, histochemical and autofluorestence studies. No particular features were found in the postmortem specimens and the mean gut diameter in relation to muscle thickness [D/M ratio] was 29.87. The white line [the site of intermyenteric plexus] was evident in half the specimens. In the postoperative specimens there was excess fobrofat in the mesentery in 40% of them and the average D/M ratio was 31.39 at the contracted segment and 32.97 above that level. No ganglion cells were present in the wall of the contracted segment but few were found in the transitional and dilated segments. The white line was indefinite in all specimens. There was a strong cholinestrase reaction, and formaline autofluorescence gave regative results for noradrenaline. Cholinestrase activity was found to parallel with the thickness of the muscle layer and consequently the clinical features, and can be used to confirm the diagnosis intraoperatively in the absence of frozen section examination. It is also very useful in the diagnosis of the ultrashort segment type

Bilharzial stricture ureter in Egypt: surgico-pathological study

Although bilharzial ureteric strictures were the subject of intensive studies in Egypt since the days of Makar [1955], their exact clinicopathological features and proper management were adequately established rather quite recently. This study based on twenty cases [nineteen males and one female aged between twenty and sixty years]. They were presented by renal aching, ureteric colic or symptoms of complications which proved to be due to ureteric strictures by IVU, cystoscopy and sometimes ultrasonography.Most strictures involved the terminal ureter, 50% being intramural, 15% juxtavesical and 15% combined; while pelviureteric and supravesical were rare [5% for each] and multiple strictures were present in 10% of cases.The techniques used in the surgical treatment of these patients depended on the site and extent ofthestricture. Theyincluded ureterocystostomy[ten cases], resection anastomosis [four cases], boari flap ureteroplasty[three cases], pyeloplasty [one case], coloureteroplasty[onecase], ileoureteroplasty [one case] and anderson-hynes pyeloplasty [one case].The relation between the anatomicopathological features of the stricture and the type of surgery adopted was illustrative enough to deserve presentation in this paper