November 29, 1965

First Surgical Success in Hirschsprung's Disease

JAMA. 1965;194(9):1022-1023. doi:10.1001/jama.1965.03090220078031

To the Editor:—  It is no rare occurrence that conceptions in medicine change from one position to the opposite. A striking illustration is the history of congenital megacolon since Hirschsprung's1 description in 1887. For decades medical literature focused all the attention on the dilated and hypertrophied colon, but resection did not achieve cure and frequently was followed by recurrence. The etiology remained obscure, and numerous theories were offered, which Swenson and his collaborators2 reviewed in 1949. Absence of the myenteric plexus in the distal part of the colon was observed by several investigators since 1920, which finally led to Swenson's recognition that the aganglionic segment of the innocent-looking area, essentially the sigmoid and rectum, was the cause of functional obstruction with secondary proximal dilation and hypertrophy. New diagnostic procedures, especially radiological demonstration of a narrow lumen distal to the ballooning bowel3 and rectal biopsy4 with histological

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