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Published on: April 26, 2019
Hirschsprung's Disease Complicated by Sigmoid Volvulus: A Systematic Review
Ufuk Uylas1, Orgun Gunes1, Cuneyt Kayaalp1
1Department of Gastroenterology Surgery, İnönü University School of Medicine, Malatya, Turkey.
Hirschsprung's disease in patients with sigmoid volvulus is more common in males under 40. Early diagnosis via rectal biopsy can reduce complications and mortality.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Medical Diagnostics
Background:
- Hirschsprung's disease and sigmoid volvulus can co-occur in patients.
- Understanding this association is crucial for effective patient management.
Purpose of the Study:
- To investigate the prevalence of Hirschsprung's disease in patients diagnosed with sigmoid volvulus.
- To review diagnostic and treatment strategies for this combined condition.
Main Methods:
- A systematic review of literature was conducted using PubMed and Scopus databases.
- Studies were screened for cases of Hirschsprung's disease associated with sigmoid volvulus.
- A total of 31 cases from 22 articles were analyzed.
Main Results:
- The majority of affected patients (97%) were under 40 years old, and 90% were male.
- Suspicion of Hirschsprung's disease led to significantly fewer relaparotomies (0% vs 37.5%, p=0.02).
- Mortality was lower in cases where Hirschsprung's disease was suspected (p=0.08).
Conclusions:
- Rectal biopsy is recommended to rule out Hirschsprung's disease in sigmoid volvulus patients under 40 with childhood constipation.
- Timely diagnosis and treatment of co-existing Hirschsprung's disease improve outcomes.
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