Hirschsprung Disease pencil thin stools pictures

An organized approach to diagnosing and managing these complications is essential. Many patients will have ongoing problems after a pull-through, including obstructive symptoms, incontinence, and enterocolitis. This can be done laparoscopically or through an umbilical incision. When doing a laparoscopic or transanal pull-through, a preliminary biopsy should be done to identify the pathological transition zone prior to beginning the anal dissection.

The laparoscopic and transanal approaches are associated with less pain, earlier feeding, and shorter hospital stay than the open procedures. The Swenson, Soave, and Duhamel procedures are all excellent, and the surgeon should do the operation that he/she is trained to do and does frequently. Most children can be treated with a one-stage pull-through procedure, although a stoma may still be appropriate for those with severe enterocolitis, malnutrition, massive colonic distention, inadequate pathology support, or long-segment disease. Hirschsprung disease must be considered in any neonate with distal intestinal obstruction, or any older child with persistent severe constipation or enterocolitis.Īlthough the diagnosis can be suspected on the basis of history, physical examination, and radiology, the gold standard for diagnosis is an adequate rectal biopsy showing aganglionosis. Long-term outcomes of Hirschsprung disease: the patients’ perspective. Reoperative surgery for Hirschsprung disease. Hirschsprung disease: do risk factors of poor surgical outcome exist? J Pediatr Surg. Pini Prato A, Gentilino V, Giunta C, Avanzini S, Mattioli G, Parodi S, et al. A prospective study of botulinum toxin for internal anal sphincter hypertonicity in children with Hirschsprung disease. One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Langer JC, Durrant AC, de la Torre L, et al. Persistent obstructive symptoms after surgery for Hirschprung’s disease: development of a diagnositc and therapeutic algorithm. Long-term morbidity in total colonic aganglionosis. Hoehner JC, Ein SH, Shandling B, Kim PCW. Primary laparoscopic-assisted endorectal colon pull-through for Hirschsprung disease: a new gold standard. Diagnosis and management of persistent problems after surgery for Hirschsprung disease in a child. Hirschsprung disease, associated syndromes, and genetics: a review.

Hirschsprung Disease pencil thin stools pictures