title: Modified Duhamel procedure for treatment of total aganglionic colon in childhood.
abstract: Based on this series of six patients with aganglionosis  of the entire colon we conclude: (1) Radiographic findings of a shortened colon of normal caliber or the presence of "jejunalization" of the colon suggest total colonic aganglionosis in patients with a suggestive history. (2) All infants with persistent obstipation, distention, and poor weight gain should have a punch biopsy of the rectum even if the barium enema is normal. (3) The Martin modification of Duhamel's operation gives functional results comparable to those achievable in children with short-segment Hirschsprung's disease. (4) The use of a stapling device to divide the septum between aganglionic colon and pulled-through  ileum is less satisfactory than using crushing clamps.
mesh_terms: D000367:Age Factors; D001706:Biopsy; D002675:Child, Preschool; D003106:Colon / Q000294:innervation*; D000013:Congenital Abnormalities / Q000601:surgery; D005725:Ganglia, Autonomic / Q000002:abnormalities*; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008531:Megacolon / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography