مقايسه بيوپسي زير مخاط بل عضله ركتوم براي جستجوي سلول كانگليون در تشخيص بيماري هيرشپرونگ

SUBMUCOSAL AND MUSCULAR LAYERS FOR GANGLION CELLS IN DIAGNOSIS OF HIRSCHSPRUNGʹS DISEASE (H.D), A COMPARATIVE

BACKGROUND AND OBJECTIVE: Hirschsprungʹ s disease (H.D) is the most common cause of lower gastrointestinal tract obstruction in newborns. Diagnosis of H.D was established by a full-thickness rectal biopsy, then it was replaced by rectal suction biopsy, that is easier and has less complications. This study was done to compare the submucosa and muscular coat of rectal wall for ganglion cells. METHODS: In this descriptive, analytical and cross-sectional study, data were obtained from 239 pathological reports in archive of Shahid Beheshti hospital, department of pathology from 1991 to 2001. Serial sections (up to 60 sections) were tested microscopically. FINDINGS: Sixty-one from 239 specimens were diagnosed as H.D (19.3%) and in 172 cases ganglion cells were present in both muscular and submucosal layers (54.43%). Sensitivity of submucosa for presence of ganglion cells was 96.6% and correlation between submucosal and muscular layers for absence of ganglion cell was 100% (p<0.05). CONCLUSION: The results showed a good correlation between advantages of serial sections of muscular and submucosal layers for presence of ganglion cells. Probability of coincident presence of ganglion cells in both layers was confirmed.