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Case Reports
July 1934

PELVIRECTAL ACHALASIA (HIRSCHSPRUNG'S DISEASE): TEMPORARY MEDICAL MANAGEMENT BY RECTAL ADMINISTRATION OF MAGNESIUM SULPHATE

Author Affiliations

SALT LAKE CITY

Am J Dis Child. 1934;48(1):123-129. doi:10.1001/archpedi.1934.01960140132013
Abstract

Reports of the successful treatment of Hirschsprung's disease by surgical division of the sympathetic nerve supply to the large bowel1 have furnished practical support to the neuromuscular theory of the origin of this condition and have at the same time served to clear up some of the confusion regarding the physiologic relationship of the autonomic nervous system to intestinal motility.2 These studies imply that there is a type of megacolon characterized by functional narrowing of the lumen of the sigmoid flexure due to persistence of normal or excessive tone at the sphincter-like3 pelvirectal flexure. Under normal conditions this tonic state of the musculature of the bowel, which is maintained by the inhibitory impulses of the thoracolumbar sympathetic outflow, yields segmentally to the oncoming peristaltic wave during defecation, thus obeying the well known law of the intestine. When, however, the portion of the intestine below the zone of

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