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ÜLKEMİZ KOŞULLARINDA NÖRONAL İNTESTİNAL DİSPLAZİ TANISI KONABİLİR Mİ?

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Classic aganglionosis is detected in only 50% of patients presenting with clinical symptoms of Hirschsprung’s disease; neuronal intestinal dysplasia (NID) is the real pathology in 20-40% of this group. Herein, the outcome of cases presenting with complaints related to bowel dysmotility and diagnosed to have NID, is evaluated. Results.- 8 NID cases, admitted to our unit had gastrointestinal decompression, barium enema and anorectal manometry, performed routinely. The full thickness rectal biopsies, peroperative colonic biopsy and anal myectomy samples were histopathologically evaluated with hematoxylin eosin stain (HE). Those cases histopathologically labeled as NID were either given oral Cisapride or surgically treated and followed up. In our domestic environment deprived of immunohistochemical facilities, diagnosis of NID is dependent on the combined experience of the pathologist, using the HE stain, and the clinical presentation of the cases. Conclusion.- Anorectal manometry and barium enema, provide nonspecific information for NID and pathology reveals the most important diagnostic criteria.
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Abstract (Original Language): 
Hirschsprung hastalığının klinik bulgular ı ile başvuran hastaların yalnızca % 50’sinde klasik aganglionosis belirlenirken, bu grup hastaların %20-40’ında nöronal intestinal displazi (NİD) sorumlu tutulan ger- çek patolojidir. Bu çalışmada, NİD tanısı alan ve barsak dismotilitesi yakınmalarıyla başvuran hastaların sonuçları değerlendirilmiştir. Cerrahpaşa Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı’nda 1990-1999 yılları aras ında 4 kız ve 4 erkek toplam 8 olguda patolojik inceleme sonucunda NİD tanısı konmuştur. Kliniğimize yatırılan tüm olgulara gastrointestinal dekompresyon, lavman opak grafisi ve anorektal manometri rutin olarak uygulandı. Tam kat rektal biyopsiler, peroperatif kolon biyopsileri ve anal miyektomi örnekleri histopatolojik olarak hematoksilen eosin boyasıyla (HE) değerlendirildi. Histopatolojik olarak NİD tanısı alan olgular oral cisapride veya cerrahi tedavi uygulanarak izlendiler. Sonuç olarak, ülkemiz koşullarında imm ünohistokimyasal olanakların olmaması nedeniyle, NİD’nin tanısı patologun HE boyas ı ile deneyimi ve olguların klinik başvurular ının birlikte değerlendirilmesi ile konulmal ıdır. Anorektal manometri ve lavman opak grafilari NİD için nonspesifik bilgi verdikleri için patoloji, tanı kriteri olarak önemini korumaktadır.
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  • 1
16-19
  • Turkish

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