Abstract. ESTOPINAN REBOLLAR, Ramón; ESTOPINAN CANOVAS, Ramón and PILA PELAEZ, Rafael. Enfermedad de Hirschsprung en un adulto. Rev Col. Resumen. LOMBANA, Luis Jorge y DOMINGUEZ, Luis Carlos. Surgery in adult Hirschsprung’s disease. Rev Col Gastroenterol [online]. , vol, n La enfermedad de Hirschsprung es una enfermedad del intestino grueso (colon). Normalmente, las heces fecales son empujadas a través del colon por.
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Annals of Diagnostic Pathology ; The Congenital Megacolon presents agonglionosis in different lengths of the intestine; many times associated to other congenital anomalies. A year-old man came to the emergency room because of diarrhea of 4 weeks duration, accompanied by constipation.
The disease predominates in females in patients above 10 years of age with a ratio of 3: Serology for Chagas’ disease was carried out in order to exclude a diagnosis of Chagas’ Disease megacolon, with negative result. Contents by Year, Volume hirschsprrung Issue. Physical examination showed a globular, asymmetrical abdomen with a 30x 15cm palpable tumor in the right abdomen. Treatment is always surgical.
Bowel sounds were minimal. The diagnostic is supported with studies of the barium enema, anorectal manometry and inmunohistochemestry. Surgical treatment for the disease was described in Hirschsprung disease with debut in adult age as acute intestinal obstruction: Other proposed mechanisms include defects in the neuroblast differentiation and accelerated destruction of ganglion cells in the intestine 4.
In adults, the treatment of choice is the Duhamel operation, which results in reduced fecal impaction after the procedure. The girl refers onset of fecal incontinence at the age of CT scan was performed, showing signs of peritonitis caused by dehiscence of ileum-rectal suture. In addition, the reported symptoms caused the girl’s parents to begin to justify such enfrrmedad fact as a result of some psychological, rather than organic, disorder. Frequency of motor alterations detected through manometry The primary defect is absence of ganglion cells in Meiss-ner plexus submucosal and Auerbach plexus myenteric in the affected segment of large bowel.
However, aganglionosis of the short-segment pathology is more frequent in males, with a mean age of 20 years at the time of medical consultation. Symptoms had worsened in recent months, prompting her to seek the evaluation of a proctologist. Como citar este artigo. Chromogranin detection of neuroendocrine cells: The infrequency of this diagnosis in this age and the clinical course of this patient underscore the uniqueness of this case. It can cause symptoms of severe chronic constipation or frequent episodes of fecal impaction.
The first and most important symptom is constipation. It is important to consider the presence of this rare pathologic process in young adult patients with treatment-refractory chronic hirschs;rung, in whom other more common diseases have been ruled out through easily accessed studies, such as imaging or anorectal physiology studies. Hirschsprung’s disease Fe is a malformation of the large intestine characterized by the hirschspeung of ganglion cells in submucosal and myenteric plexus, which produces a functional obstruction and dilatation proximal to the affected segment 1.
Discussion HD is a congenital anomaly that occurs due to a discontinuation of the cranial-caudal migration of neural crest cells, which are responsible for innervation of the colon, or when the ganglion cells undergo premature death between 5th and 12th weeks of pregnancy. We include a review of existing literature. The surgical approach will depend on length of aganglionic area, length and reversibility of colonic dilatation, and nutritional status of patient.
A resection of distal rectal mucosa of the aganglionic segment is performed, maintaining muscular wall of this segment. In this case, the aganglionic segment is not removed, but a rear dissection is performed.
Typically, patients go to the doctor with a long-standing history of constipation requiring frequent laxative use. It consists in a rear section of muscular wall of rectum starting from dentate line by transanal waywhich removes some of the top segment of internal anal sphincter, getting relief stenosis.
When he arrived at the hospital, he told doctors that he had not had a bowel movement for 83 days. This item has received. Later, a barium enema Fig.
Vólvulo en adultos
A CT scan was performed, showing a massive dilatation of sigmoid colon, which compresses liver to the right upper quadrant, stomach into the left upper quadrant and bowel loops into the right flank Figs. In this latter case, HD may affect the entire colon and even the small intestine. Fecal incontinence is not typical in adults, unlike children. Under a Creative Commons license. Hirschsprung’s Disease HDalso known as congenital aganglionic megacolon, is an anomaly characterized by an absence of ganglion cells in the myenteric and submucosal plexuses in a variable bowel segment.
Bcl-2 detection of enteric neurons: Department of General and Digestive Surgery. Discussion Some authors have maintained that Hirschsprung’s disease in adults probably correspond to congenital cases not diagnosed previously, and consequently it is likely that, in fact, adult Hirschsprung’s disease does not really exist as an independent entity.
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No nausea or vomiting.
Vólvulo en adultos | HCA Healthcare
Compared with the Soave and Swenson procedures, it is superior in terms of impotence rate, anastomotic dehiscence and reservoir function to minimize soiling 8. Female patient, 13 years old, coming from Campo Grande – MS, reports that since birth had intestinal enfermddad, with mean bowel movements at every days with hardened feces, being followed-up by a pediatrician and in treatment for functional constipation.
Enfermedad de Hirschsprung en adultos. Enfermdead disease is characterized by absence of ganglion cells in submucosal and myenteric plexus of distal bowel.
hirschprung Nevertheless, the literature considers as the procedure of choice the Duhamel technique in only one surgical time, 2 which reduces the hospitalization time. Conventional anorectal manometry trace showing the absence of the inhibitory rectoanal reflex with the maximum tolerable rectal capacity.
The key finding in barium enema is the existence of a transition zone “funnel” between distal aganglionic bowel normal or narrow and proximal dilated.