Related Experiment Videos
Diverticulosis in total colonic aganglionosis
Insights
Total colonic aganglionosis (TCA) in infants can be challenging to diagnose early. Acquired colon diverticula may serve as a key indicator for this condition in infants with intestinal obstruction.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Total colonic aganglionosis (TCA) is a severe form of Hirschsprung disease.
- Delayed diagnosis of TCA in infants can lead to significant morbidity.
Observation:
- Two infants with TCA extending into the distal ileum experienced diagnostic delays.
- Initial radiologic findings suggestive of TCA were not definitive.
- Both infants developed multiple acquired colon diverticula over time.
Findings:
- Acquired colon diverticula increased in number and size during observation.
- Diverticula are likely a consequence of the spasticity in the aganglionic colon.
- The presence of diverticula provides strong evidence for TCA in infants.
Implications:
- Acquired diverticula may aid in the early diagnosis of TCA in infants.
- Recognizing diverticula in infants can improve diagnostic timelines for TCA.
- This finding highlights a potential late-onset radiologic sign for TCA.
Abstract:
Two infants with total colonic aganglionosis (TCA) extending into the distal part of the ileum are described. Considerable diagnostic delay occurred with the correct diagnosis established first at 3 and 8 months, respectively. Radiologic findings compatible with TCA such as prolonged barium retention, reflux into ileum following barium enema, and foreshortening of colon were not clearly evident initially. Both patients demonstrated multiple acquired colon diverticula which increased both in number and size during the period of observation. These diverticula are probably a late manifestation of the spastic state of the anganglionic colon. Thus demonstration of diverticula supplies a strong evidence of TCA in infants with intestinal obstruction.