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Enteric mucocele formation after endorectal pull-through: report of a case
1Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Insights
A rare case of enteric mucocele formation occurred in a child post-Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Case Reports
Background:
- Hirschsprung's disease requires surgical correction, often involving pull-through procedures.
- Proximal intestinal neuronal dysplasia can complicate surgical outcomes.
- Previous ineffective pull-through and stoma revisions preceded the current complication.
Observation:
- A 4-year-old boy developed ileus, peritonitis, and an abdominal mass.
- Laparotomy revealed complete colon atresia and a proximal enteric mucocele.
- The patient had undergone multiple prior surgical interventions for Hirschsprung's disease.
Findings:
- Enteric mucocele formation is a novel complication following endorectal pull-through for Hirschsprung's disease.
- Complete colon atresia was identified as the cause of the mucocele.
- Surgical resection of the mucocele resulted in an uneventful recovery.
Implications:
- Highlights a rare but serious complication of Hirschsprung's disease surgery.
- Suggests the need for careful surgical technique and monitoring post-endorectal pull-through.
- Underscores the importance of considering enteric mucocele in post-operative ileus and abdominal masses.
Abstract:
We report a case of enteric mucocele formation in a 4-year-old boy after endorectal pull-through correction for Hirschsprung's disease with proximal intestinal neuronal dysplasia. On 17 April 1997, when the patient was 2 years old, a loop ileostomy was performed after an ineffective endorectal pull-through operation involving the right colon. Because of frequent prolapse of the stoma, when the child was two-and-a-half years old an end ileostomy was made by a resection of the distal ileotoma and redundant terminal ileum. When he was 4 years old, he was readmitted because of ileus, peritonitis, and a huge abdominal mass. Complete atresia of the colon at the level of pelvic reflection with proximal enteric mucocele formation was noted at laparotomy. He made an uneventful recovery after resection of the mucocele. This is the first reported case of such a complication after an endorectal pull-through operation. The possible causes and techniques for the prevention of this complication are discussed.