Hirschsprung's disease overview: Difference between revisions
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Hirschsprung's disease involves an enlargement of the [[colon (anatomy)|colon]], caused by [[bowel obstruction]] resulting from an [[ganglion|aganglionic]] section of [[bowel]] (the normal [[Enteric nervous system|enteric nerves]] are absent) that starts at the anus and progresses upwards. The length of bowel that is affected varies but seldom stretches for more than a foot or so. | Hirschsprung's disease involves an enlargement of the [[colon (anatomy)|colon]], caused by [[bowel obstruction]] resulting from an [[ganglion|aganglionic]] section of [[bowel]] (the normal [[Enteric nervous system|enteric nerves]] are absent) that starts at the anus and progresses upwards. The length of bowel that is affected varies but seldom stretches for more than a foot or so. | ||
==Historical Perspective== | |||
This disease is named for [[Harald Hirschsprung]], the Danish [[physician]] who first described the disease in 1886, describing two infants who had died with swollen bellies. The autopsies showed identical pictures with a pronounced dilatation and hypertrophy of the colon as the dominant features. | |||
==Diagnosis== | |||
===Other Imaging Findings=== | |||
Hirschsprung’s disease is a [[congenital]] disorder of the colon in which certain nerve cells, known as ganglion cells, are absent, causing chronic constipation <ref>Worman and Ganiats 1995, Am Fam Physician 51, 487-494 [http://www.ncbi.nlm.nih.gov/pubmed/7840044]</ref>. A [[barium enema]] is the mainstay of diagnosis of Hirschsprung’s, though a rectal [[biopsy]] showing the lack of ganglion cells is the only certain method of diagnosis. | |||
==Treatment== | |||
===Surgery=== | |||
The usual treatment is "pull-through" surgery where the portion of the colon that does have nerve cells is pulled through and sewn over the part that lacks nerve cells (National Digestive Diseases Information Clearinghouse). For a long time, Hirschsprung’s was considered a multi-factorial disorder, where a combination of nature and nurture were considered to be the cause (Madsen 19). However, in August of 1993, two articles by independent groups in ''Nature Genetics'' said that Hirschsprung’s disease could be mapped to a stretch of [[chromosome 10 (human)|chromosome 10]] <ref>{{Cite journal | |||
| author = [[M. Angrist]], [[E. Kauffman]], [[S. A. Slaugenhaupt]], [[T. C. Matise]], [[E. G. Puffenberger]], [[S. S. Washington]], [[A. Lipson]], [[D. T. Cass]], [[T. Reyna]] & [[D. E. Weeks]] | |||
| title = A gene for Hirschsprung disease (megacolon) in the pericentromeric region of human chromosome 10 | |||
| journal = [[Nature genetics]] | |||
| volume = 4 | |||
| issue = 4 | |||
| pages = 351–356 | |||
| year = 1993 | |||
| month = August | |||
| doi = 10.1038/ng0893-351 | |||
| pmid = 8401581 | |||
| url = http://www.nature.com/ng/journal/v4/n4/abs/ng0893-351.html | |||
}}</ref><ref>Lyonnet et al. 1993, Nature Genetics 4, 346-350 [http://www.nature.com/ng/journal/v4/n4/abs/ng0893-346.html]</ref>. This research also suggested that a single gene was responsible for the disorder. However, the researchers were unable to isolate the single gene that they thought caused Hirschsprung’s. | |||
==References== | ==References== | ||
Revision as of 16:07, 19 March 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]
Overview
Hirschsprung's disease involves an enlargement of the colon, caused by bowel obstruction resulting from an aganglionic section of bowel (the normal enteric nerves are absent) that starts at the anus and progresses upwards. The length of bowel that is affected varies but seldom stretches for more than a foot or so.
Historical Perspective
This disease is named for Harald Hirschsprung, the Danish physician who first described the disease in 1886, describing two infants who had died with swollen bellies. The autopsies showed identical pictures with a pronounced dilatation and hypertrophy of the colon as the dominant features.
Diagnosis
Other Imaging Findings
Hirschsprung’s disease is a congenital disorder of the colon in which certain nerve cells, known as ganglion cells, are absent, causing chronic constipation [1]. A barium enema is the mainstay of diagnosis of Hirschsprung’s, though a rectal biopsy showing the lack of ganglion cells is the only certain method of diagnosis.
Treatment
Surgery
The usual treatment is "pull-through" surgery where the portion of the colon that does have nerve cells is pulled through and sewn over the part that lacks nerve cells (National Digestive Diseases Information Clearinghouse). For a long time, Hirschsprung’s was considered a multi-factorial disorder, where a combination of nature and nurture were considered to be the cause (Madsen 19). However, in August of 1993, two articles by independent groups in Nature Genetics said that Hirschsprung’s disease could be mapped to a stretch of chromosome 10 [2][3]. This research also suggested that a single gene was responsible for the disorder. However, the researchers were unable to isolate the single gene that they thought caused Hirschsprung’s.
References
- ↑ Worman and Ganiats 1995, Am Fam Physician 51, 487-494 [1]
- ↑ M. Angrist, E. Kauffman, S. A. Slaugenhaupt, T. C. Matise, E. G. Puffenberger, S. S. Washington, A. Lipson, D. T. Cass, T. Reyna & D. E. Weeks (1993). "A gene for Hirschsprung disease (megacolon) in the pericentromeric region of human chromosome 10". Nature genetics. 4 (4): 351–356. doi:10.1038/ng0893-351. PMID 8401581. Unknown parameter
|month=ignored (help) - ↑ Lyonnet et al. 1993, Nature Genetics 4, 346-350 [2]