Megacolon in adulthood after surgical treatment of Hirschsprung’s disease in early childhood

Figure 1 Contrast medium enema of the distal bowel shows a distal stenosis and a megacolon proximal to the stenosis.

Figure 2 Anorectal manometry shows absence of the recto-anal inhibitory reflex after inflation of an intrarectally placed balloon with 40 mL of air.

Figure 3 Rectal biopsy (AChE-staining) shows increased activity of acetylcholinesterase in the mucosal layer of the dilated segment.

Figure 4 Megacolon in situ.

Figure 5 Instantaneous section (Peripherin-immmunohistochemistry) shows normal formation of plexus myentericus.

Figure 6 Electron microscopic sections show thickened parasympathetic nerve fibers in the distal part of the resected segment (A) and normal numbers of ganglia in the proximal part (B).