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[Stenosis of the colon in childhood]
Insights
Colonic stenosis in infants, including cases linked to necrotizing enterocolitis and Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatology
Context:
- Colonic stenosis presents a significant challenge in pediatric surgical care.
- This study reviews six cases of colonic stenosis in infants aged 9 days to 4 months.
- Cases were observed between 1982 and 1985 at Bambino Gesù Hospital.
Purpose:
- To analyze the clinical presentation, diagnosis, and surgical management of colonic stenosis in infants.
- To highlight the association between colonic stenosis, necrotizing enterocolitis, and Hirschsprung's disease.
- To emphasize the diagnostic utility of anorectal manometry.
Summary:
- Six pediatric patients (3 male, 3 female) with colonic stenosis were treated.
- Etiologies included necrotizing enterocolitis (3 cases) and Hirschsprung's disease (3 cases).
- Surgical interventions involved resection of stenotic segments (5 patients) and colostomy with pull-through procedures (3 patients).
- Stenosis locations varied, including descending colon, sigmoid, and rectosigmoid, with two patients having multiple stenotic areas.
Impact:
- The findings underscore the importance of considering both necrotizing enterocolitis and Hirschsprung's disease in neonatal colonic stenosis.
- Anorectal manometry is crucial for diagnosing Hirschsprung's disease in these cases.
- Effective surgical strategies can improve outcomes for infants with colonic stenosis.
Abstract:
The authors report 6 cases of colonic stenosis (three males and three females, range of age 9 days-4 months) observed from 1982 to 1985 in the Department of Pediatric Surgery in Bambino Gesù Hospital. Three out of six have been admitted with the diagnosis of necrotizing enterocolitis soon after birth. The authors have observed 2 cases of colonic stenosis in neonatal age, 1 case aged month, both suffering from Hirschsprung's disease. A file for the diagnosis has been performed for all patients. Stenosis have been observed in the descending colon, sigmoid colon, rectosigmoid tract, multiple stenosis were present in 2 patients. In 5 patients the surgical treatment has been the removal of stenotic tract. In three patients a colostomy on transverse colon has been performed followed by abdominal perineal intestinal lowering. The authors stress the importance of anorectal manometry among investigations usually performed to exclude Hirschsprung's disease.