直腸粘膜生検による Hirschsprung 病の診断基準に関する酵素組織化学的,組織計測的研究

概要

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Rectal mucosal biopsy specimen obtained from 110 infants with abdominal distention and constipation were examined by histochemical method (Acethylcholinesterase stain: Ach. E. Stain). Fifty-two patients were diagnosed as Hirschsprung's disease. In fourty-five of these patients, the diagnosis was confirmed by operation. In this study, we found that the pattern of nerve fiber proliferation was not uniform. The proliferating pattern of nerve fiber was classified into four types. I. total layer type (typical type) (15 cases), II. lamina propria mucosal type (10 cases), III. lamina submucosal type (15 cases), and IV. lamina propria mucosal and lamina submucosal type (5 cases). In seven of 52 cases, had not the size of the specimen was not adequate for this study. When the specimens showed the type I. by Ach. E. Staining, the diagnosis of Hirschsprung's disease was easy. However, the diagnosis was difficult in the types of II. III. & IV. In these groups, detection of the Meissner's ganglion cells is the most important factor for diagnose of Hirschsprung's disease. In order to find the Meissner's ganglion cells, a biopsy specimen which was taking at 5 to 10mm oral to the dentate line should be subjected to histochemical study of the submucosal layer.
日本小児外科学会の論文
1985-02-20