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[Hirschsprung in children over 6 years of age]
Carlos Baeza-Herrera1, Vicente A Herrera-del Prado, Luis Manuel García-Cabello
1Departamento de Cirugía General, Hospital Pediátrico Moctezuma, México, D.F., México.
Insights
Hirschsprung's disease (colonic agangliosis) is rare in older children, often presenting with severe constipation. The Duhamel procedure offers a successful surgical solution for these cases.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Colorectal Surgery
Context:
- Hirschsprung's disease, or colonic agangliosis, is typically diagnosed in infants.
- Presentation in schoolchildren and adolescents is uncommon, often with severe chronic constipation or encopresis.
- This study focuses on the diagnosis and surgical management of Hirschsprung's disease in an older pediatric population.
Purpose:
- To report on the diagnosis and treatment of Hirschsprung's disease in schoolchildren and adolescents.
- To evaluate the efficacy of the Duhamel procedure in this patient group.
Summary:
- A 5-year study identified six male patients aged 11 years with Hirschsprung's disease.
- Patients presented with classic symptoms, severe constipation, or encopresis, with one case involving significant fecal impaction.
- Diagnosis was confirmed via barium enema and biopsy; all patients underwent colostomy, and eight had successful Duhamel procedures.
Impact:
- Highlights the occurrence of Hirschsprung's disease in older children, challenging typical infant diagnosis.
- Demonstrates the Duhamel procedure as an effective surgical option for pediatric patients with Hirschsprung's disease.
- Contributes to understanding the management of rare pediatric colorectal conditions.
Introduction:
Hirschsprung's disease or colonic agangliosis is a rare condition in schoolchildren and adolescents. It is common in infants and chronic constipation is the usual symptom.
Materials, Methods, And Results:
In a period of 5 years, 11-years-old patients were diagnosed and treated for Hirschsprung's disease. We studied six male patients; mean age was 8.6 years. All patients had classic disease and nine, severe chronic constipation, and two were admitted with encopresis. One had 10 kg of feces in 40 cm of colon. Diagnosis was established with barium enema and tissue biopsy. All patients had colostomy. In eight patients, Duhamel procedure was performed with good results.
Conclusions:
This disease is a rare condition in older patients and Duhamel procedure is a good surgical option.