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Ileocecal interposition for Hirschsprung's disease: a case report

F Penninckx1, W Van den Eynde, A D'Hoore

  • 1UZ Gasthuisberg - Abdominal Surgery, Leuven, Belgium. freddy.penninckx@uz.kuleuven.ac.be

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|February 26, 2008
PubMed

Insights

Ileocecal interposition (ICI) is an effective rescue surgery for complex Hirschsprung disease when standard approaches fail. This technique preserves bowel length and creates a functional neorectal reservoir, yielding excellent long-term results.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Colorectal Surgery

Background:

  • Congenital aganglionosis, or Hirschsprung disease, affects the colon's nerve supply, leading to functional obstruction.
  • Standard surgical treatments may be challenging in cases with extensive aganglionosis or prior surgical interventions like colostomy.
  • The interruption of the paracolic arcade during prior colostomy construction complicated the surgical approach in this case.

Observation:

  • A 14-month-old girl with congenital aganglionosis up to the sigmoid colon underwent an ileocecal interposition (ICI).
  • The left colon could not be mobilized due to a compromised paracolic arcade from a previous colostomy.
  • The patient had a history of a preceding colostomy construction.

Findings:

  • The ileocecal interposition (ICI) procedure was performed as a rescue intervention.
  • Fourteen years post-reconstruction, the patient exhibited excellent functional outcomes.
  • Daily bowel movements were 1-2, with normal continence for flatus and stool.

Implications:

  • Ileocecal interposition (ICI) serves as a viable rescue procedure for complex cases of Hirschsprung disease.
  • This technique maximizes the use of normally innervated bowel, preserving functional length.
  • ICI creates a neorectal reservoir, contributing to successful long-term functional results and improved quality of life.

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