Physiological Operation for Idiopathic Congenital Megacolon (Hirschsprung's Disease)

The striking clinical features, the unique pathological findings, and the evasiveness of the etiological factors have made idiopathic congenital megacolon (Hirschsprung's disease) a provocative and stimulating enigma. Recent observations by Whitehouse and Kernohan¹and Swenson and co-workers²have resulted in a better understanding of the pathogenesis of this disease and have permitted a more rational approach to its treatment. The purpose of this paper is to discuss our experiences with 15 patients in whom colonic function was studied by means of fluoroscopy and roentgenograms, after the administration of a barium enema. As a result of these studies, a new surgical approach to the treatment of Hirschsprung's disease, which has given excellent results in the patients so treated, was devised. ETIOLOGY Since Hirschsprung's report before the Berlin Congress for Children's Diseases, in 1886,³many theories as to the cause of this disease have been advanced. For the most