Diagnosis of congenital megacolon: an analysis of 501 patients.

Today, almost 90 yr after Harald Hirschsprung described two cases of “Constipation in the Newborn due to Dilatation and Hypertrophy of the Colon” before the Society of Pediatrics in Berlin,1 the child with congenital megacolon is still a diagnostic challenge to the pediatrician and pediatric surgeon. The presenting signs and symptoms can be easily mistaken for mechanical bowel obstruction in the critically ill neonate or for severe intractable diarrhea in the infant. In addition, the barium enema may be difficult to interptet, especially in the patient under 1 mo. It is not surprising that many of these infants are subjected to exploratory laparotomy before a diagnosis of congenital megacolon is considered. In an attempt to clarify the important points in identifying the newborn patient suspected of having congenital megacolon, this report presents a retrospective detailed review of the presenting signs and symptoms and hospital evaluation of 501 patients diagnosed as having congenital megacolon.