Paediatria Croatica, Vol. 58 No. 3, 2014.
Recenzija, Prikaz slučaja
https://doi.org/10.13112/PC.2014.39
Coloanal anastomosis in the treatment of congenital megacolon in children: case report
Matija Evačić
Mirko Žganjer
; Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb
Ante Čizmić
Marko Mesić
Arnes Rešić
Sažetak
Congenital megacolon or Hirschsprung’s disease was fi rst described by Harold Hirschsprung. It is a congenital intestinal aganglionosis
as a result of arrested fetal development of the myenteric nervous system. Normal intestinal motility depends on a coordinated
segmental contraction waves followed immediately by smooth muscle relaxation as it propagates caudally. Patients with
Hirschsprung’s disease lack functional myenteric nervous system in the aff ected distal intestine and have ineff ective distal peristalsis.
The clinical outcomes are failure to pass meconium shortly after birth, constipation, abdominal distension, palpable loops of bowel,
vomiting, watery diarrhea in the newborn, poor weight gain, slow growth and malabsorption. The aganglionic distal segment of
the bowel is the reason for dilatation of the proximal part of the colon or opening debility of the anal sphincter system. Hirschsprung’s
disease is aff ecting 1:5000 to 1:8000 live births. Most cases are diagnosed before the patient is 10 years of age. Occasionally, patients
present with this problem at a later age. Recently we operated on a 12-year-old patient with this condition. First we performed surgical
resection of the rectosigmoid colon with closure of the rectal stump and formation of an end colostomy, also known as Hartmann’s
procedure. Three months later, the rectum was extirpated and coloanal anastomosis formed. Based on the uneventful postoperative
course, good patient’s condition and clinical tests, the treatment of congenital megacolon was successful.
Ključne riječi
Hirschprung disease; anastomosis, surgical; rectum; child
Hrčak ID:
142304
URI
Datum izdavanja:
25.9.2014.
Posjeta: 2.677 *