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A stercoraceous ulcer of the colon in neglected Hirschsprung's disease
D Golinsky1, E Freud, R M Steinberg
1Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petah-Tikva, Israel 49202, USA.
Insights
A chronic colon ulcer was discovered in a child with undiagnosed Hirschsprung's disease (HD). This stercoraceous ulcer was likely caused by fecal impaction, not an intrinsic bowel defect.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
Background:
- Hirschsprung's disease (HD) is a congenital disorder characterized by the absence of ganglion cells in the distal bowel.
- Delayed diagnosis of HD can lead to severe complications, including bowel obstruction and malnutrition.
Observation:
- A large, nonspecific, chronic ulcer was identified in the sigmoid colon of a 13-year-old patient.
- The patient had a history of neglected, undiagnosed Hirschsprung's disease.
Findings:
- The colonic ulcer is not a known complication or intrinsic defect associated with Hirschsprung's disease.
- The ulcer is presumed to be a stercoraceous ulcer, resulting from prolonged fecal stasis and pressure.
Implications:
- This case highlights the importance of early diagnosis and management of Hirschsprung's disease to prevent severe complications.
- Stercoraceous ulcers should be considered in the differential diagnosis of colonic ulcers in patients with undiagnosed or neglected HD.
Abstract:
A large, nonspecific, chronic ulcer was found in the sigmoid colon of a 13-year-old child with neglected, undiagnosed Hirschsprung's disease (HD). There is no known association between HD and colonic ulcers, suggesting that the ulcer was a true stercoraceous ulcer of the colon and not an intrinsic defect of the aganglionotic bowel.