Introduction Hirschsprung’s disease is neurocristopathy, characterized by a halt in the normal migration of scallop nerve cells and their differentiation. Electron microscopic examination reveals neurochemical ultrastructural findings, which are important not only for studying the pathogenesis of the disease, but also for developing methods of treating this complex disease.

Materials and methods. Studies were performed on 10 patients aged 2 weeks to 3 years (5 patients) and 14 to 16 years (5 patients) in the agangliosis zone and in the area of the intestine proximal to it. Submicroscopic organization in intestinal biopsy specimens was studied by electron microscopic methods.

Results. An electron microscopic examination of the colon sections of children of different age groups (from 2 weeks to 16 years) with a clinical diagnosis of Hirschsprung’s disease, excised during surgery in agangliosis zones and proximal colon with undisturbed innervation, showed a violation of the organization of many structural components regulatory systems of the intestinal wall – nervous, immune, endocrine and conductive. For each age period, certain patterns of ultrastructural changes in the colon are revealed, reflecting the depth and prevalence of the pathological process. In older children, an increase in destructive processes in all layers of the colon wall is noted. In place of the destroyed muscle cells, the growth of loose connective tissue and collagen fibers occurs, which replace the muscle layer, making the intestinal wall more regid. In zones of agangliosis and sections of the intestine, proximal to it, cells of the immune system (eosinophils, mast cells) and endocrinocytes undergo destructive processes.

Conclusion Ultramicroscopic changes in the walls of the colon, proximal to the agangliosis zone, indicate both primary underdevelopment of the neuromuscular, endocrine and immune systems in the intestinal wall, and secondary degenerative changes that occur with age of the patients. The more pronounced degenerative processes in the wall of the ganglionic section of the colon, the more significant the violation of its function.

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