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March 1920


Author Affiliations

From the Department of Pediatrics, University of California Medical School.

Am J Dis Child. 1920;19(3):167-180. doi:10.1001/archpedi.1920.01910210001001

In reviewing the literature that has appeared on the subject of dilatation of the colon in children one is struck by the lack of definiteness pertaining to this condition. The various theories put forth endeavoring to point out the etiology of this abnormality are but a frank admission of our uncertainty. Likewise, the medical treatment of intestinal dilatation with its accompanying constipation is highly unsatisfactory, both to the parents of the patient and to the physician.

In the first place, What degree of hypertrophy and dilatation constitutes the so-called Hirschsprung's disease, otherwise known as congenital idiopathic dilatation of the colon, or megacolon? If one makes roentgenograms in all cases of persistent constipation, especially those beginning in infancy, he would find that many of the sigmoids are looped, twisted, redundant, dilated and hypertrophied. The past histories of these cases are practically identical. In spite of rational feeding during the early part