NADPH-diaphorase histochemistry: a reliable test for the intraoperative diagnosis of Hirschsprung's disease.
Seromuscular biopsies were obtained from eight cases, at various levels, during a Swanson pull-through operation. The specimens were examined by using NADPH-diaphorase histochemistry. In the ganglionic segment of bowel, there were a large number of NADPH-diaphorase-positive nerve fibers in the circular and longitudinal muscles, and the myenteric ganglia stained strongly. In the transitional segment of bowel, there were a few NADPH-diaphorase-positive nerve fibers in the circular and longitudinal muscles, and the myenteric ganglion cells were smaller. In the aganglionic segment of bowel, there was a lack of expression of NADPH-diaphorase in the circular and longitudinal muscles. Hypertrophied nerve trunks in the myenteric plexus were stained. NADPH-diaphorase histochemistry is a simple, reliable, and rapid method for the intraoperative evaluation of the aganglionic segment of bowel. This technique allows intraoperative demonstration of innervation patterns of smooth muscle in normal and HD bowel, and provides accurate identification of ganglion cells in the ganglionic segment.
Kobayashi
H
H
Children's Research Centre, Our Lady's Hospital for Sick Children, Dublin, Ireland.
Hirakawa
H
H
Puri
P
P
D015415:Biomarkers; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D017615:Enteric Nervous System / Q000378:metabolism; D006627:Hirschsprung Disease / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007430:Intraoperative Care; D009252:NADPH Dehydrogenase / Q000378:metabolism*
D015415:Biomarkers; D009252:NADPH Dehydrogenase