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Zeng FTA, Makaba SM, Hager J, Sergi CM. Congenital segmental dilatation of the intestine: an in-depth review. J Matern Fetal Neonatal Med 2023; 36:2259047. [PMID: 37726217 DOI: 10.1080/14767058.2023.2259047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/03/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE Congenital segmental dilatation of the intestine (CSDI) is a rare gastrointestinal condition. We conducted a scoping review through MEDLINE and Google Scholar, collecting data from 1959 through August 2020 to better understand this peculiar disease. METHODS The clinical and pathological features of 150 patients were reviewed. RESULTS The mean age was 25.9 days, and 61.3% of patients were male. An antenatal diagnosis was made in 15.3% of patients. Predominant symptoms included abdominal distension (83.9%) and vomiting (61.3%). Pallor and anemia were associated with ileal CSDI. The most common sites of the lesion were the ileum (56%) and colon (27.3%). Associated anomalies occurred in 57.3% of the patients, of which the most common included other abnormalities of the digestive system (69.8%), abdominal wall (19.8%), and cardiovascular system (11.6%). Resection and anastomosis was performed in 83.3% of patients. Postoperative complications occurred in 10%. Normal ganglion cells were commonly found (97.3%), while muscle layer hypertrophy and atrophy were found in 14.7% and 13.3% of the patients, respectively. Abnormal interstitial cells of Cajal were identified in four patients. Death occurred in 12.7% of patients. Demise was significantly associated with the duodenal location of CSDI (Mantel-Cox test, p = 0.002). CONCLUSION CSDI remains poorly understood, and mortality is associated chiefly with its duodenal location. Further research is needed, and biorepositories should be promptly set up to study this disease in the future better.
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Affiliation(s)
- Florent T A Zeng
- Department of Surgery, Université de Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Samuel M Makaba
- Service of Pediatrics, Centre Médical du Centre ville, Lubumbashi, Democratic Republic of Congo
| | - Josef Hager
- Department of Pediatric Surgery, Medical University of Innsbruck, Austria
| | - Consolato M Sergi
- Anatomic Pathology Division, Children's Hospital of Eastern Ontario (CHEO), University of Ottawa, ON, Canada
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Muto M, Matsufuji H, Taguchi T, Tomomasa T, Nio M, Tamai H, Tamura M, Sago H, Toki A, Nosaka S, Kuroda T, Yoshida M, Nakajima A, Kobayashi H, Sou H, Masumoto K, Watanabe Y, Kanamori Y, Hamada Y, Yamataka A, Shimojima N, Kubota A, Ushijima K, Haruma K, Fukudo S, Araki Y, Kudo T, Obata S, Sumita W, Watanabe T, Fukahori S, Fujii Y, Yamada Y, Jimbo K, Kawai F, Fukuoka T, Onuma S, Morizane T, Ieiri S, Esumi G, Jimbo T, Yamasaki T. Japanese clinical practice guidelines for allied disorders of Hirschsprung's disease, 2017. Pediatr Int 2018; 60:400-410. [PMID: 29878629 DOI: 10.1111/ped.13559] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/27/2018] [Accepted: 03/07/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite the presence of ganglion cells in the rectum, some patients have symptoms similar to those of Hirschsprung's disease. A consensus has yet to be established regarding the terminology for these diseases. We defined this group of diseases as "allied disorders of Hirschsprung's disease" and compiled these guidelines to facilitate accurate clinician diagnosis and provide appropriate treatment strategies for each disease. METHODS These guidelines were developed using the methodologies in the Medical Information Network Distribution System (MINDS). Of seven allied disorders, isolated hypoganglionosis; megacystis-microcolon-intestinal hypoperistalsis syndrome; and chronic idiopathic intestinal pseudo-obstruction were selected as targets of clinical questions (CQ). In a comprehensive search of the Japanese- and English-language articles in PubMed and Ichu-Shi Web, 836 pieces of evidence related to the CQ were extracted from 288 articles; these pieces of evidence were summarized in an evidence table. RESULTS We herein outline the newly established Japanese clinical practice guidelines for allied disorders of Hirschsprung's disease. Given that the target diseases are rare and intractable, most evidence was drawn from case reports and case series. In the CQ, the diagnosis, medication, nutritional support, surgical therapy, and prognosis for each disease are given. We emphasize the importance of full-thickness intestinal biopsy specimens for the histopathological evaluation of enteric ganglia. Considering the practicality of the guidelines, the recommendations for each CQ were created with protracted discussions among specialists. CONCLUSIONS Clinical practice recommendations for allied disorders of Hirschprung's disease are given for each CQ, along with an assessment of the current evidence. We hope that the information will be helpful in daily practice and future studies.
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Affiliation(s)
- Mitsuru Muto
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Hiroshi Matsufuji
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Tomoaki Taguchi
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Takeshi Tomomasa
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Masaki Nio
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Hiroshi Tamai
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Masanori Tamura
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Haruhiko Sago
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Akira Toki
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Shunsuke Nosaka
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Tatsuo Kuroda
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Masahiro Yoshida
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Atsushi Nakajima
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Hiroyuki Kobayashi
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Hideki Sou
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Kouji Masumoto
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yoshio Watanabe
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yutaka Kanamori
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yoshinori Hamada
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Atsuyuki Yamataka
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Naoki Shimojima
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Akio Kubota
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Kosuke Ushijima
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Ken Haruma
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Shin Fukudo
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yuko Araki
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Takahiro Kudo
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Satoshi Obata
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Wataru Sumita
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Toshihiko Watanabe
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Suguru Fukahori
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yoshimitsu Fujii
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yoshiyuki Yamada
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Keisuke Jimbo
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Fujimi Kawai
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Tomoya Fukuoka
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Shinsuke Onuma
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Toshio Morizane
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Satoshi Ieiri
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Genshiro Esumi
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Takahiro Jimbo
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Tomoko Yamasaki
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
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