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Journal of Immunology Research 2021The association between inflammatory processes and intestinal neuronal destruction during the progression of Chagasic megacolon is well established. However, many other... (Review)
Review
The association between inflammatory processes and intestinal neuronal destruction during the progression of Chagasic megacolon is well established. However, many other components play essential roles, both in the long-term progression and control of the clinical status of patients infected with . Components such as neuronal subpopulations, enteric glial cells, mast cells and their proteases, and homeostasis-related proteins from several organic systems (serotonin and galectins) are differentially involved in the progression of Chagasic megacolon. This review is aimed at revealing the characteristics of the intestinal microenvironment found in Chagasic megacolon by using different types of already used biomarkers. Information regarding these components may provide new therapeutic alternatives and improve the understanding of the association between infection and immune, endocrine, and neurological system changes.
Topics: Animals; Biomarkers; Cellular Microenvironment; Chagas Disease; Endocrine System; Humans; Immune System; Inflammation; Megacolon; Nervous System; Neuroimmunomodulation; Trypanosoma cruzi
PubMed: 33928170
DOI: 10.1155/2021/6668739 -
British Medical Journal Mar 1980
Topics: Aged; Colonic Neoplasms; Constipation; Dietary Fiber; Diverticulum, Colon; Humans; Intestinal Obstruction; Megacolon
PubMed: 6244872
DOI: No ID Found -
The Veterinary Clinics of North... Mar 1999Many cats have one or two episodes of constipation without further recurrence, although others progress to complete colonic failure. Middle-aged male cats are... (Review)
Review
Many cats have one or two episodes of constipation without further recurrence, although others progress to complete colonic failure. Middle-aged male cats are particularly at risk for the clinical continuum of constipation, obstipation, and dilated megacolon. Pelvic canal stenosis and nerve injury are minor causes in the development of this syndrome. In most affected cats, the underlying pathogenesis appears to involve colonic smooth muscle dysfunction. In this group of cats, it is not yet clear whether this disorder represents a primary or secondary (resulting from long-standing constipation and colonic distension) abnormality. Many cats with mild to moderate constipation respond to conservative medical management (e.g., dietary fiber supplementation, emollient or hyperosmotic laxatives, colonic prokinetic agents). Indeed, early use of colonic prokinetic agents is likely to prevent the progression of constipation of obstipation and dilated megacolon in many cats. Some cats may become refractory to these therapies, however, as they progress through moderate or recurrent constipation to obstipation and dilated megacolon. These cats eventually require colectomy. Cats have a generally favorable prognosis for recovery following colectomy, although mild to moderate diarrhea may persist for 4 to 6 weeks postoperatively in some cases.
Topics: Animals; Cat Diseases; Cats; Megacolon
PubMed: 10202804
DOI: No ID Found -
Archives of Disease in Childhood Apr 1964
Review
Topics: Biopsy; Child; Diagnosis; Hirschsprung Disease; Humans; Infant; Infant, Newborn; Megacolon; Pathology; Radiography; Rectum; Surgical Procedures, Operative
PubMed: 14131948
DOI: 10.1136/adc.39.204.109 -
Seminars in Pediatric Surgery Apr 2022Hirschsprung-associated enterocolitis (HAEC) was described in 1886 by Harald Hirschsprung and is a potentially deadly complication of Hirschsprung Disease. HAEC is... (Review)
Review
Hirschsprung-associated enterocolitis (HAEC) was described in 1886 by Harald Hirschsprung and is a potentially deadly complication of Hirschsprung Disease. HAEC is classically characterized by abdominal distension, fever, and diarrhea, although there can be a variety of other associated symptoms, including colicky abdominal pain, lethargy, and the passage of blood-stained stools. HAEC occurs both pre-operatively and post-operatively, is the presenting symptom of HSCR in up to 25% of infants and varies in overall incidence from 20 to 60%. This article reviews our current understanding of HAEC pathogenesis, diagnosis, and treatment with discussion of areas of ongoing research, controversy, and future investigation.
Topics: Enterocolitis; Hirschsprung Disease; Humans; Infant
PubMed: 35690459
DOI: 10.1016/j.sempedsurg.2022.151162 -
Seminars in Pediatric Surgery Jun 2019Hirschsprung disease affects many children every year around the world. Currently, there is an extensive menu of diagnostic methods, and surgical treatments. This... (Review)
Review
Hirschsprung disease affects many children every year around the world. Currently, there is an extensive menu of diagnostic methods, and surgical treatments. This situation compels the physicians to follow the rationale of these interventions. The comprehensive diagnosis and treatment of Hirschsprung disease need singular procedures. The clear understanding of how to perform each of these techniques, as well as to read the results is mandatory. Otherwise, the medical team may perform unconscious errors and fall into traps. Many errors still happen in patients with Hirschsprung, resulting in a spectrum of problems; from delayed diagnosis to unnecessary colectomies. In other patients, the damage to the anal canal results in fecal incontinence. When this is established, it is an unreversed and devastating social problem. This article describes why these errors occur and how to prevent them.
Topics: Biopsy; Diagnostic Techniques, Digestive System; Fecal Incontinence; Hirschsprung Disease; Humans; Infant; Infant, Newborn; Intraoperative Complications; Medical Errors; Patient Safety; Postoperative Complications; Surgical Procedures, Operative
PubMed: 31171150
DOI: 10.1053/j.sempedsurg.2019.04.013 -
British Medical Journal Aug 1971
Topics: Abdomen; Gastrointestinal Diseases; Humans; Infant; Megacolon; Polycystic Kidney Diseases
PubMed: 5558204
DOI: 10.1136/bmj.3.5770.373 -
Journal of the American Veterinary... Nov 2021To evaluate outcomes in cats undergoing subtotal colectomy for the treatment of idiopathic megacolon and to determine whether removal versus nonremoval of the...
OBJECTIVE
To evaluate outcomes in cats undergoing subtotal colectomy for the treatment of idiopathic megacolon and to determine whether removal versus nonremoval of the ileocecocolic junction (ICJ) was associated with differences in outcome.
ANIMALS
166 client-owned cats.
PROCEDURES
For this retrospective cohort study, medical records databases of 18 participating veterinary hospitals were searched to identify records of cats with idiopathic megacolon treated by subtotal colectomy from January 2000 to December 2018. Data collection included perioperative and surgical variables, complications, outcome, and owner perception of the procedure. Data were analyzed for associations with outcomes of interest, and Kaplan-Meier survival time analysis was performed.
RESULTS
Major perioperative complications occurred in 9.9% (15/151) of cats, and 14% (12/87) of cats died as a direct result of treatment or complications of megacolon. The median survival time was not reached. Cats with (vs without) a body condition score < 4/9 (hazard ratio [HR], 5.97), preexisting heart disease (HR, 3.21), major perioperative complications (HR, 27.8), or long-term postoperative liquid feces (HR, 10.4) had greater hazard of shorter survival time. Constipation recurrence occurred in 32% (24/74) of cats at a median time of 344 days and was not associated with retention versus removal of the ICJ; however, ICJ removal was associated with long-term liquid feces (OR, 3.45), and a fair or poor outcome on owner assessment (OR, 3.6).
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that subtotal colectomy was associated with long survival times and a high rate of owner satisfaction. Removal of the ICJ was associated with less favorable outcomes in cats of the present study.
Topics: Animals; Cat Diseases; Cats; Colectomy; Constipation; Humans; Megacolon; Retrospective Studies; Treatment Outcome
PubMed: 34727062
DOI: 10.2460/javma.20.07.0418 -
Diseases of the Colon and Rectum Jul 1990Hirschsprung's disease in the adolescent and adult is a rare and often misdiagnosed cause of lifelong refractory constipation. Two adolescent and three adult patients... (Review)
Review
Hirschsprung's disease in the adolescent and adult is a rare and often misdiagnosed cause of lifelong refractory constipation. Two adolescent and three adult patients with Hirschsprung's disease treated between 1973 and 1987 at the University of Michigan Medical Center are reported. Each patient presented with chronic constipation requiring enemas, cathartics, and multiple hospital admissions for management. Diagnosis in each case was made with barium enema and full-thickness rectal biopsy. Four patients underwent endorectal pull-through procedures, all with good long-term results. The fifth patient, initially treated with a Duhamel retrorectal pull-through procedure, required reoperation for constipation secondary to a retained rectal septum. Review of 199 cases of adult Hirschsprung's disease enables comparison of the various operative procedures for this disorder with respect to postoperative complications and functional outcomes. Anorectal myectomy with low anterior resection, the Duhamel-Martin procedure, and the Soave endorectal pull-through procedure are the most acceptable methods for surgical management.
Topics: Adolescent; Adult; Anal Canal; Biopsy; Constipation; Enema; Hirschsprung Disease; Humans; Methods; Muscles; Postoperative Complications; Rectum
PubMed: 2193786
DOI: 10.1007/BF02052222 -
Chinese Medical Journal Jun 2016To systematically summary the updated results about the pathogenesis of Hirschsprung's-associated enterocolitis (HAEC). Besides, we discussed the research key and... (Review)
Review
OBJECTIVE
To systematically summary the updated results about the pathogenesis of Hirschsprung's-associated enterocolitis (HAEC). Besides, we discussed the research key and direction based on these results.
DATA SOURCES
Our data cited in this review were obtained mainly from PubMed from 1975 to 2015, with keywords "Hirschsprung enterocolitis", "Hirschsprung's enterocolitis", "Hirschsprung's-associated enterocolitis", "Hirschsprung-associated enterocolitis", "HAEC", and "EC".
STUDY SELECTION
Articles regarding the pathogenesis of HAEC were selected, and the articles mainly regarding the diagnosis, surgical approach, treatment, and follow-up were excluded.
RESULTS
Several factors, mainly including mucus barrier, intestinal microbiota, and immune function, as well as some other factors such as genetic variations and surgical reasons, have been found to be related to the pathogenesis of HAEC. Changed quantity and barrier property of mucus, different composition of microbiota, and an abnormal immune state work together or separately trigger HAEC.
CONCLUSIONS
The maintenance of intestinal homeostasis is due to a well cooperation of microbiota, mucus barrier, and immune system. If any part presents abnormal, intestinal homeostasis will be broken. Meanwhile, for patients with Hirschsprung's disease or HAEC, dysfunction of these parts has been found. Thus, the happening of HAEC may be mainly attributed to the disorders of intestinal microbiota, mucus barrier, and immune system.
Topics: Animals; Enterocolitis; Hirschsprung Disease; Humans; Intestines
PubMed: 27270548
DOI: 10.4103/0366-6999.183433