Transient functional obstruction of the colon in neonates: An investigation by rectal manometry and biopsy

Between 1975 and 1983, 17 neonates with transient functional obstruction of the colon were admitted to our department. In 12 cases a colostomy was necessary. On three occasions the colostomy was performed too late and the patients died. Rectal biopsies and anorectal manometry were performed repeatedly in the other nine cases. Despite radiologic signs suggestive of Hirschsprung's disease, true aganglionosis including the ultrashort segment was excluded. Rectoanal manometry four months after colostomy was still pathologic as in aganglionosis in four cases, but five had returned to normal. Of the rectal biopsies five showed signs of ganglion-cell immaturity and three were normal. One to two years later, rectoanal manometry was normal in all cases except in one of the five with ganglion-cell immaturity. The colostomy was closed in all cases with normal manometry without relapse of the obstruction in long-term follow-up.