Constipation and congenital disorders of the myenteric plexus.
Full-thickness muscle biopsies have been taken from patients with severe disabling chronic constipation that has not responded to conservative measures. Assessment by neurohistochemical techniques has revealed that a range of neuronal dysplasias of the myenteric plexus are responsible in many cases; these include aganglionosis (Hirschsprung's disease), hypoganglionosis and hyperganglionosis. In cases considered unlikely to be Hirschsprung's disease on clinical grounds, the procedure used has often been anorectal myectomy; this has not only provided tissue for diagnosis but has also been of therapeutic value in most cases of hypoganglionosis and some cases reported as 'normal'.
D000328:Adult; D002908:Chronic Disease; D003248:Constipation / Q000209:etiology*; D005725:Ganglia, Autonomic / Q000002:abnormalities / Q000473:pathology; D006627:Hirschsprung Disease / Q000150:complications / Q000473:pathology; D006801:Humans; D007422:Intestines / Q000294:innervation; D009130:Muscle, Smooth / Q000473:pathology; D009197:Myenteric Plexus / Q000002:abnormalities* / Q000473:pathology