Abstract
Raj P Kapur, MD, PhD, as the editor of this Special Issue, has collected a series of articles carrying the reader through the care of a patient with Hirschsprung Disease, from the diagnosis, to surgery, to the postoperative period. The authors end with an article entitled, “Are we underdiagnosing Hirschsprung disease?”, a provocative assessment of the gap between current knowledge surrounding diagnosis and treatment, and the potential underdiagnosis inherent in our current understanding and methodologies.
Dr Kapur is a recognized expert in the pathology of Hirschsprung Disease. He is responsible not only for the groundbreaking experiments utilizing mice to study the migration of neural crest cells into the intestine, but also for taking these observations into the human to identify histologic parameters to support the diagnosis. As is typical of his approach to pathology, Dr Kapur is joined in this series of articles by clinical colleagues to provide not only the pathologist’s perspective but also that of those directly caring for the patient.
Dr Lusine Ambartsumyan is the lead author on the chapter entitled, “Diagnosis of Hirschsprung disease,” lending a gastroenterologist’s perspective from patient presentation to confirmation of the diagnosis of Hirschsprung disease. As a pediatric gastroenterologist, Dr Ambartsumyan’s research focuses on the pathophysiology and management of defecation disorders in the pediatric population. Dr Caitlin Smith, a pediatric surgeon, takes the lead on the chapter entitled, “Surgery, surgical pathology, and postoperative management of patients with Hirschsprung disease,” describing the various surgical procedures for patients with Hirschsprung disease and highlighting the role of the pathologist in the surgical procedure. Dr Smith’s interests include Hirschsprung Disease, and she is the program director for the multidisciplinary Reconstructive Pelvic Medicine Clinic at Seattle Children’s.
“Although in some instances, data from original investigations are presented, the volume is not primarily for this purpose. The articles are not addressed to pediatric pathologists alone, but to all individuals in closely related fields of endeavor: general pathologists, pediatricians, pediatric surgeons, radiologists, obstetricians, neonatologists, perinatologists and developmental cell biologists.” Those words are from a Preface written by Drs. Harvey Rosenberg and Robert Bolande in the first volume of Perspectives in Pediatric Pathology, published in 1973. Perspectives was meant for a diverse group that cares for children. This Special Issue highlights this interdependency by collecting the knowledge and observations of disciplines caring for the patient. We are grateful to those who have gone before us and espoused the vision that comes full circle in this issue.