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Updated: Oct 13, 2026
Rectal Organoid Morphology Analysis (ROMA): A Diagnostic Assay in Cystic Fibrosis
Published on: June 10, 2022
Insights
Megarectum in infants can stem from psychological issues or inner sphincter fibrosis. Diagnosis involves radiology, manometry, and biopsy, with treatment potentially including surgery and neuropsychiatric care.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Surgery
- Developmental Psychology
Background:
- Megarectum classification in infants requires careful diagnostic consideration.
- Distinguishing between congenital and acquired forms is crucial for effective management.
- Psychological factors can play a significant role in infantile constipation and megarectum.
Observation:
- Diagnostic tools include clyster radiology, rectal manometry, and biopsy.
- Histological examination post-sphincteromyectomy reveals fibrosis and nerve regression in some cases.
- Affective disturbances may initiate a cascade leading to intestinal distension and secondary organic changes.
Findings:
- Many cases of infantile megarectum, particularly those involving inner sphincter fibrosis, are secondary and reactive rather than primary congenital.
- Psychogenic forms of megarectum are identifiable and require specific diagnostic approaches.
- Surgical intervention (sphincteromyectomy) combined with neuropsychiatric treatment is often necessary.
Implications:
- Accurate diagnosis of infantile megarectum necessitates a multidisciplinary approach.
- Understanding the secondary and psychogenic origins can guide treatment strategies.
- Early identification and intervention for psychological factors may prevent the progression to organic megarectum.
Abstract:
The criteria employed in the classification of megarectum in infancy are briefly reviewed and its diagnosis is discussed. Stress is laid on the importance of clyster radiology and rectal manometry. Biopsy extended to the point of true sphincteromyectomy may also prove resolutive. Lastly, infantile neuropsychiatry is unmistakably indicated in diagnosing the psychological origin of many of these forms. Aganglionic forms are quickly described and attention is directed to those due to fibrosis of the inner sphincter. Most of such cases are shown to be of secondary, reactive, rather than primary congenital, origin on histological inspection after surgery. Lastly, consideration is given to essentially psychogenic forms. The picture observed in a case treated by sphincteromyectomy with histological evidence of interstitial fibrosis with muscle and nerve regression suggested that affective disturbances lead first to persistent constipation, followed by abnormal distension of the last segments of the intestine. Subsequent regression results in an organic evolution independent of the original disturbance, so that surgery must be resorted to, as well as neuropsychiatric treatment.
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