title: The Appendix and Aganglionosis. A Note of Caution-How the Histology Can Mislead the Surgeon in Total Colonic Hirschsprung Disease.
abstract: We present the case of a child with presumed total colonic Hirschsprung disease (HD) to highlight the problems the surgeon is likely to encounter if he/she relies on the appendix alone for histopathologic diagnosis. A newborn male infant, who was presumed to have total colonic aganglionosis when the appendix was found to be aganglionic at the time of initial exploratory laparoscopy, was managed with an ileostomy in the newborn period; however, at the time of his planned pull-through procedure, the rectal biopsy revealed normal ganglion cells. The child was subsequently managed with ileostomy closure and observed for normal feeding and stooling prior to discharge home. We discuss the histopathologic findings of the appendix in separate cases of confirmed total colonic HD seen in our center, and review the normal histopathologic findings of the appendix.
authors.affiliation: Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, Ohio, United States ; Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, Ohio, United States.
authors.forename: Victoria Alison
authors.initials: VA
authors.lastname: Lane
authors.affiliation: Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, Ohio, United States.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Levitt
authors.affiliation: Department of Pathology, Nationwide Children's Hospital, Columbus, Ohio, United States.
authors.forename: Peter
authors.initials: P
authors.lastname: Baker
authors.affiliation: Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, Ohio, United States ; Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, Ohio, United States.
authors.forename: Peter
authors.initials: P
authors.lastname: Minneci
authors.affiliation: Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, Ohio, United States ; Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, Ohio, United States.
authors.forename: Katherine
authors.initials: K
authors.lastname: Deans
keywords: Hirschsprung; appendix; histopathology