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CC BY 4.0 · European J Pediatr Surg Rep. 2020; 08(01): e99-e101
DOI: 10.1055/s-0040-1721049
Case Report

Image of the Month: Decision-Making in Surgery for Late Onset Hirschsprung Disease

Anisha Apte
1   Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
,
Elise McKenna
2   Department of General and Thoracic Surgery, Children's National Medical Center, Washington, District of Columbia, United States
,
Marc A. Levitt
1   Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
2   Department of General and Thoracic Surgery, Children's National Medical Center, Washington, District of Columbia, United States
3   Division of Colorectal and Pelvic Reconstruction Surgery, Children's National Medical Center, Washington, District of Columbia, United States
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Abstract

We present a case of a 14-year-old boy with chronic distension, poor growth, and chronic constipation. He undergoes anorectal manometry and rectal biopsy, confirming the diagnosis of Hirschsprung disease (HD). The case is presented with a key image and associated questions to prompt discussion on strategies for management and treatment of HD in late-diagnosed children.

Keywords

Hirschsprung disease - chronic distension - colonic dysmotility - chronic constipation - pull-through


Publication History

Received: 29 May 2020

Accepted: 18 August 2020

Article published online:
03 December 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Hackam DJ, Reblock KK, Redlinger RE, Barksdale Jr EM. Diagnosis and outcome of Hirschsprung's disease: does age really matter?. Pediatr Surg Int 2004; 20 (05) 319-322
    CrossrefPubMedSearch in Google Scholar
  • 2 De La Torre L, Langer JC. Transanal endorectal pull-through for Hirschsprung disease: technique, controversies, pearls, pitfalls, and an organized approach to the management of postoperative obstructive symptoms. Semin Pediatr Surg 2010; 19 (02) 96-106
    CrossrefPubMedSearch in Google Scholar
  • 3 Rentea RM, Halleran DR, Ahmad H, Maloof E, Wood RJ, Levitt MA. Transanal-only Swenson-like pull-through for late diagnosed Hirschsprung disease. J Surg Case Rep 2019; 2019 (12) rjz341
    CrossrefPubMedSearch in Google Scholar
  • 4 Peña A, Elicevik M, Levitt MA. Reoperations in Hirschsprung disease. J Pediatr Surg 2007; 42 (06) 1008-1013 , discussion 1013–1014
    CrossrefPubMedSearch in Google Scholar
  • 5 Langer JC. Laparoscopic and transanal pull-through for Hirschsprung disease. Semin Pediatr Surg 2012; 21 (04) 283-290
    CrossrefPubMedSearch in Google Scholar