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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.

Journal of Indian Association of Pediatric Surgeons
|April 24, 2018
PubMed

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.
Keywords:
Coloniccytomegalovirusstricture

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