Patient's question:
Patient Age: 4 yearsDetailed Medical Condition and Purpose of Consultation: The child underwent surgery for Hirschsprung's disease at the age of 3 months. However, after the surgery, the child experiences frequent but small amounts of bowel movements daily, leading to redness and skin breakdown in the buttocks. Experts, what are some effective methods to address this phenomenon?
Doctor's answer:
Hello: This disease is a congenital disorder. In the lower segment of the sigmoid colon or the upper segment of the rectum, there is a congenital absence (aganglionosis) or reduction of ganglion cells in the myenteric plexus of the intestinal wall. This prevents the sacral parasympathetic preganglionic fibers from forming synapses with ganglion cells and releasing postganglionic fibers, allowing the preganglionic fibers to directly enter the intestinal wall. This lack of ganglion cell regulation by the parasympathetic preganglionic fibers causes contraction and spasm (narrowed segment) of the intestinal wall. As a result, feces stagnate in the upper segment of the intestine, leading to persistent constipation. Ultimately, this segment of the intestine becomes hypertrophied and dilated (dilated segment). Therefore, surgical resection of the narrowed segment of the intestine lacking ganglion cells can potentially cure the disease.