ABSTRACT
The authors report the results of a retrospective study of 36 patients with fistula-in-ano (FIA) and/or perianal abscess (PA) presenting during a 3-year period. In 76.2% of the 21 patients with FIA, the fistulae developed in the first 2 years of life. For eight of the 16 patients who underwent fistulectomy, histological examination of the excised fistulae showed an epithelial lining of the tract mixed with stratified squamous, transitional and columnar epithelium. The early onset of FIA, the high percentage of bilateral and multiple fistulae, and the presence of these types of epithelium lining support a congenital etiology of FIA in children. In boys, a causal relationship exists between PA and FIA.
Subject(s)
Abscess/surgery , Anus Diseases/surgery , Rectal Fistula/surgery , Abscess/microbiology , Abscess/pathology , Anus Diseases/microbiology , Anus Diseases/pathology , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Rectal Fistula/microbiology , Rectal Fistula/pathology , Retrospective Studies , Surgical Procedures, Operative/methodsABSTRACT
Two cases of "Megacystis-microcolon-intestinal hypoperistalsis syndrome" are described. These appear to be the seventh and eighth cases in published literature. Consistent with the two published reports, both our patients were newborn female infants who manifested a large bladder, associated with unused colon and functional intestinal obstruction. While the earlier published reports mention a full complement of normal mature ganglion cells in all parts of the bowel, the two cases described here showed " dysganglionosis " to some extent, in the form of fewer and shrunken neurones along with other mature-looking neurones in some parts of the bowel. The bladder was available for histologic examination only in the second case and showed apparently normal innervation. Hence, it is felt that the intestinal obstruction in these cases could have been due to a disturbance in bowel innervation.
Subject(s)
Colon/abnormalities , Gastrointestinal Motility , Intestinal Obstruction/congenital , Peristalsis , Urinary Bladder Diseases/congenital , Dilatation, Pathologic/congenital , Female , Ganglia/abnormalities , Humans , Infant, Newborn , SyndromeABSTRACT
Eleven cases of neonatal intestinal obstruction associated with a white ileal meconium plug are described; 6 of these presented with complications--such as, giant meconium pseudocyst, perforation, volvulus, or atresia. Most of these complications are presumed to have arisen during the intrauterine period. Only one patient could be relieved of the ileal meconium plug by enemas. The condition of ileal meconium plug is not as benign as a meconium plug in the rectum or distal colon. A plea is made to restrict the name meconium plug syndrome to cases in which the meconium plug is white and chalky and the consequent intestinal obstruction can be relieved by enemas, without evidence of intestinal dysfunction in later life.
Subject(s)
Ileal Diseases/etiology , Intestinal Obstruction/etiology , Meconium , Enema , Female , Humans , Ileal Diseases/complications , Ileal Diseases/therapy , Infant, Newborn , Intestinal Obstruction/complications , Intestinal Obstruction/therapy , Male , SyndromeABSTRACT
Three cases of aganglionosis of the entire bowel are presented. Eight other cases from English literature are reviewed. Two histologic types are noted. The incidence of Hirschsprung's disease in sibling is four out of 11.
