The diagnosis and treatment of neonatal intestinal obstruction caused by hypoganglionosis

Objective To investigate the diagnostic and therapeutic methods for neonatal intesti-nal obstruction caused by hypoganglionosis. Methods A retrospective analysis of 11 cases with hy-poganglionosis identified by the pathological examination after operation, who suffered obstruction in the neonatal period, was carried out. The data included clinical presentations, barium enema, anorec-tal electromanometry and histochemical staining for acetylcholinesterase (ACHE). Results Out of 6 cases underwent primary radical operation, the narrow and distention segments were noted in 4 pa-tients by barium enema, and barium stagnation over 24 hours was observed in 5 patients; the electro-manometric examination showed recto-anal inhibition reflex (RAIR) appeared in 5 patients; 4 patients were positive in AChE histochemical staining of rectal mucosal biopsy. Out of 5 cases underwent en-terostomy in the neonatal period, 3 children underwent staged radical operation and 2 underwent isola-ted intestinal anastomosis. All cases were diagnosed by the pathological examination. All patients re-covered without wound dehiscence, intestinal fistula, constipation recurrence or fecal incontinence. Conclusions Neonatal intestinal obstruction can be caused by hypoganglionsis. Pathological examina-tion is a reliable method for the diagnosis of hypoganglionosis. Isolated intestinal anastomosis can he taken if intestinal peristalsis function recovers after intestinal obstruction is cured by enterostomy. Otherwise, resection of the pathological segment of bowels and colorectostomy is an effective treat-ment. Key words: Neonate;  Aganglionosis;  Colonic;  Diagnosis;  Treatment