Persistent or Acquired Aganglionosis
This problem may be due to an error in histological analysis, a transition zone pull-through or loss of ganglion cells and can be diagnosed by performing a biopsy above the colo-anal anastomosis. The specimen from the original operation should be reviewed and further sections should be taken circumferentially at the resection margin since the transition zone can be asymmetrical in children with HD. In most cases, the best treatment for persistent or acquired aganglionosis is a repeat pull-through, which can be accomplished using either a Soave or a Duhamel approach.
Ashcraft's Pediatric surgery, 6th Ed, 2014.

Postoperative Acquired Aganglionosis??? How it can developed? I cannot understand. Is it acquired or residual aganglionic zone?

_**Persistent or Acquired Aganglionosis**_ This problem may be due to an error in histological analysis, a transition zone pull-through or loss of ganglion cells and can be diagnosed by performing a biopsy above the colo-anal anastomosis. The specimen from the original operation should be reviewed and further sections should be taken circumferentially at the resection margin since the transition zone can be asymmetrical in children with HD. In most cases, the best treatment for persistent or acquired aganglionosis is a repeat pull-through, which can be accomplished using either a Soave or a Duhamel approach. **Ashcraft's Pediatric surgery, 6th Ed, 2014.** Postoperative Acquired Aganglionosis??? How it can developed? I cannot understand. Is it acquired or residual aganglionic zone?
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