الفهرس 
General Features of Hirschsprung’s diseaseOnly 14 pages are availabe for public view
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Abstract
Background: Despite the increased knowledge of Hirschsprung’s Disease (HD) by advances in the understanding of the embryogenesis and surgical care, still, significant complications continue to be associated with the different procedures. However the most annoying complications are the persistent constipation and the recurrent enterocolitis induced by transitional zone pull-through or residual aganglionosis. Nevertheless in literature review both were mentioned as the major cause of redo-pullthrough(1).
Aim of the Work: The aim of this study is to define the characteristic histopathological features of the transitional zone in patients with HD, and it is impact on the clinical outcome.
Methodology:
Study: Retrospective and prospective cohort study was conducted to study the histopathological features (regarding ganglion cells and nerve bundle) of the transitional zone in patients with HD from 2010-2016, and its impact on the clinical outcome. Was performed in Pediatric surgery department in Ain Shams university hospitals in the period between 2015-2016.
Results Clinical outcome postoperatively among the 35 studied cases 71.4% were of good outcome (group A) they have normal or semi normal bowel habits after surgery; while (group B) 28.6% had recurrent bowel symptoms. The two groups were compared with their histopathologicaly findings. The significant findings were found in group B: the histopathological findings in the proximal wide assumed to be healthy part Ganglion cells are present in all cases and are classic, inspite of that Aurbach’s nerve bundle show focal disarray in 28.6% and are unmylinated in 65.7% ,moreover their mean diameter 65.8±16.2 (µm) with range of 40.5–117.2 (µm). Meissner’s nerve bundle in the same specimens show mean diameter 36.0±10.4 (µm) with range 11.5–62.8 (µm). Cases with postoperative group B had significantly more frequent focal disarray of nerve bundles, acute& mixed inflammatory cells and larger nerve bundles diameter.
Conclusion: Wide zone Auerbach’e nerve bundles mean diameter ≥68.0 µm had high sensitivity & (Negative Predictive value) NPV and other diagnostic characteristics moderate in prediction of abnormal bowel.