سؤال congenital megacolon

[طالب طب2]

why in congenital meacolon there is constipation and obstruction due to spasm although there is no ganglon elles

[د/ خالد صديق]

functional obstruction
i.e no ganglion cells --- no miesner and aurbach plexus so no propagation of food
so somesort of obstruction = constipation

[طالب طب2]

شكرا يا خالد باشا
بس ده بيقولوا في الكتاب ان ال حتة اللي مفيهاش اعصاب دي هي دي الحتة اللي قافشة وعشان كده فيه امساك والام بتدخل صابعها عشان الواد ينزل
ايه للي خلي الحتة دي تقفش كده رغم ان مفيهاش اعصاب
ده اللي معصبني

[د-وسام]

the absence of ganglion cells and normal nerve fibres from the distal (or lower) 3 to 40 cm (1 to 16 inches) of the large intestine. Neuromuscular transmission is absent from this segment, and peristalsis cannot occur. It is thus a functional obstruction. In 10 percent of cases a larger segment is involved and, on rare occasions, the whole colon. The area of normal intestine above the obstruction works harder to push on the fecal contents, and eventually the muscle of the normal segment thickens. The entire colon thus slowly becomes more and more distended and thick-walled.
the ganglion cell mediates relaxation of the smooth ms of a segment when the smooth ms of the above segment contracts