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Cytomegalovirus as a Cause of Colonic Stricture-Simulating Hirschsprung's Disease
Chiranjiv Kumar1, Meera Luthra1
1Department of Paediatric Surgery, Medanta - The Medicity, Gurugram, Haryana, India.
Abstract:
Colonic stenosis/atresias account for only 5%-15% of all atresias. Colonic stenosis is rarer than atresia and mostly occurs in ascending and transverse colon. Gastrointestinal sequelae of cytomegalovirus (CMV) are rare, frequently requires surgical intervention for diagnosis and management. We describe a 5-month-old female child with complaints of recurrent abdominal distension, vomiting, and constipation for 2 months simulating Hirschsprung's disease. After barium enema, the baby was taken up for surgery. Intraoperatively, we found a colonic stricture in the descending colon. The biopsy showed localized CMV infection.
Insights
Cytomegalovirus (CMV) infection can cause rare gastrointestinal issues, including colonic strictures in infants. This case highlights CMV as a cause of intestinal obstruction mimicking Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Infectious Diseases
Background:
- Colonic stenosis/atresias are rare congenital anomalies, comprising 5%-15% of all intestinal atresias.
- Gastrointestinal manifestations of cytomegalovirus (CMV) infection are uncommon in infants.
- Distinguishing these conditions from Hirschsprung's disease can be challenging.
Observation:
- A 5-month-old infant presented with chronic abdominal distension, vomiting, and constipation, mimicking Hirschsprung's disease.
- Barium enema and subsequent intraoperative findings revealed a colonic stricture in the descending colon.
- Histopathological examination of the biopsy confirmed localized cytomegalovirus infection.
Findings:
- The study identified a rare case of colonic stricture caused by localized cytomegalovirus infection in an infant.
- The clinical presentation simulated Hirschsprung's disease, emphasizing the need for a broad differential diagnosis.
- Surgical intervention was necessary for both diagnosis and management of the CMV-induced colonic stricture.
Implications:
- This case underscores the importance of considering cytomegalovirus infection in the differential diagnosis of neonatal intestinal obstruction and strictures.
- Early recognition and appropriate management of CMV-related gastrointestinal complications are crucial to prevent surgical morbidity.
- Further research into the pathogenesis and treatment of CMV-induced intestinal strictures in infants is warranted.