[The differential diagnosis of megacolon in childhood (author's transl)]

The diagnosis of Hirschsprung's disease can be established praeoperatively by the histochemical demonstration of an increased acethylcholinesterase activity in rectal mucosal biopsies. Furthermore the intraoperative diagnosis of the extension of the aganglionary or hypoganglionary segment can be improved by histochemical demonstration of dehydrogenases in the intramural parasympathetic plexus. By these means it becomes easy to localize the correct position of the enterostoma as well as to determine the length of the segment, which should be resected. The results of our histochemical investigation on 92 cases of megacolon, especially on 12 cases of Hirschsprung's disease were reported. The histochemical diagnosis was confirmed finally by an extensive examination of the resected bowel segment.