Congenital long colon

　　Some authors examined the intestinal ganglion cells of 3 children with sigmoid colon elongation syndrome, of which 2 were normal and 1 was reduced. Chronic constipation caused by sigmoid colon elongation may have two reasons: primary (HDAD) and secondary (simple elongation). The etiology of sigmoid colon elongation syndrome needs further study. Klimanov (1973) found that the intestinal wall muscle fibers of patients with sigmoid colon elongation were fibrotic and accompanied by connective tissue edema. On the basis of muscle fiber hypertrophy, there was infiltration of lymphocytes, atrophy of intestinal mucosa, and widening of lymphatic spaces.

　　After congenital long colon is complicated with enteritis, local and systemic infectious toxic symptoms may occur, even leading to megacolon crisis. Delayed treatment can cause intestinal perforation, peritonitis, sepsis due to severe abdominal distension, the condition will deteriorate rapidly, and ultimately lead to the death of the patient.

　　In Lyonyushkin's data, 60% of children with sigmoid colon elongation syndrome experience constipation within the first year of life, during the transition from breastfeeding to artificial feeding or adding complementary foods. Clinically, the clinical manifestations of sigmoid colon elongation syndrome are divided into three stages: compensation, sub-compensation, and de-compensation.

　　1. Compensation stage

　　The characteristics of the compensation stage are occasional intestinal dysfunction. X-ray examination shows that the sigmoid colon is elongated, which is actually a healthy child. Some complain of occasional lower abdominal pain, and some patients have abdominal pain accompanied by vomiting and distension.

　　2. Sub-compensation stage

　　The main symptoms of sub-compensation stage are intermittent constipation, that is, defecating once every 2 to 3 days. Children in this stage often have abdominal pain and distension, and there are signs of feces accumulating along the colon.

　　3. De-compensation stage

　　The characteristics of this period are more obvious intestinal dysfunction, constipation lasting for more than 5 days. Some children can no longer defecate spontaneously and can only defecate after enema.

　　Congenital long colon belongs to congenital malformation. The prevention of congenital malformation is divided into the following aspects:

　　1. In the early stages of pregnancy, pregnant women should avoid fever and colds. High fever can cause fetal malformation and is related to the sensitivity of pregnant women to high fever and other factors.

　　1. Pregnant women should avoid close contact with cats and dogs. Bacteria-carrying cats are also a major source of infectious diseases that can cause fetal malformation.

　　2. Pregnant women should avoid wearing heavy makeup every day. Toxic substances such as arsenic, lead, and mercury in cosmetics can affect the normal development of the fetus.

　　3. Pregnant women should avoid emotional tension during pregnancy. When pregnant women are emotionally tense, adrenal cortical hormones may hinder the integration of embryonic tissue. If it occurs in the first three months of pregnancy, it can cause fetal malformation.

　　4. Pregnant women should avoid drinking alcohol. Alcohol can pass through the placenta to the developing embryo, causing serious harm to the fetus.

　　The auxiliary examinations for congenital long colon mainly include the following types:

　　1. Abdominal Standing Radiography

　　Abdominal standing radiography can preliminarily determine the location and severity of the lesion and the possible prognosis.

　　2. Barium Enema Examination of the Lower Gastrointestinal Tract

　　Barium enema examination of the lower gastrointestinal tract is still widely used in clinical practice and is one of the most important and accurate examination methods. Barium enema examination can clearly diagnose the location, extent, intestinal dilatation, and barium excretion of the lesion, and at the same time, it is helpful for related differential diagnosis.

　　3. Rectal Manometry Examination

　　The pressure measurement content of rectal manometry is the relaxation reflex of the internal anal sphincter and the pressure changes in various parts of the anal canal. This method is safe and simple, but requires large and expensive medical equipment. Due to the influence of the subjective judgment of the operator, the objective nature of the examination results is not strong, and there is a certain error rate, especially in newborns and young infants, the accuracy is poor.

　　4. Rectal Mucosal Biopsy and Enzymatic Examination

　　When clinical physical examinations and radiological examinations cannot accurately determine the cause of the disease, rectal mucosal biopsy and enzymatic examination can be considered. This method is accurate, objective, and reliable for diagnosis, but it is an invasive examination method, so it is often forced to be adopted last in clinical practice.

　　Patients with congenital long colon should eat light and easily digestible foods and foods rich in vitamins and plant proteins. In addition, patients should also pay attention to avoiding spicy, greasy, and cold foods.

　　The treatment methods for congenital long colon include non-surgical and surgical treatments.

　　1. Non-surgical Treatment

　　Non-surgical treatment includes bowel training, diet, and medication, etc., and requires repeated treatment. Bowel training and dietary therapy are of great significance in preventing bowel dysfunction and are also applicable to children with existing bowel dysfunction. Oral liquid paraffin is beneficial for clearing accumulated feces in the sigmoid colon and promoting the recovery of sigmoid colon function. The earlier non-surgical treatment is started and the more persistent it is, the better the efficacy.

　　2. Surgical Treatment

　　The surgical indications for sigmoid colon冗长症 are very strict, and the dynamic function of the sigmoid colon should be judged comprehensively based on clinical, X-ray and other data. The surgical methods are radical surgery for congenital megacolon (Swenson modified method) and sigmoid colon resection (Rehbein method) for treatment.