Ruankha Bilommi
Departement of Pediatrics Surgery, Indonesia
Title: THE BEST AND ACURATE WAY FOR HIRSCHSPRUNG DISEASE DIAGNOSIS ; ACETYLCHOLINESTERASE (ACHE) VS CALRETININ IMMUNOHISTOCHEMISTRY
Biography
Biography: Ruankha Bilommi
Abstract
Hirschsprung’s disease is caused by the failed migration of colonic ganglion cells during gestation. Varying lengths of the distal colon are unable to relax, causing functional colonic obstruction. Early diagnosis is important to prevent complications. A rectal suction biopsy can detect hypertrophic nerve trunks and the absence of ganglion cells in thee colonic submucosa, confirming the diagnosis. Acetylcholinesterase histochemistry (AChE) facilitates diagnosis but is not universally employed, in part because it requires special tissue handling. Calretinin immunohistochemistry (IHC) may be a useful alternative, because loss of calretinin immunoreactive nerves reportedly correlates spatially with aganglionosis. In suction rectal biopsies that contain ganglion cells, small nerves in the lamina propria, muscularis mucosae, and superficial submucosa contain granular aggregates of calretinin immunoreactivity.