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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Given the low incidence of HD in adults, it is difficult to compare different procedures. It can cause symptoms of severe chronic constipation or frequent episodes of fecal impaction. In the pediatric population a constipation history since the first month of life, the delay on the elimination of meconium beyond the 24 hours, abdominal distension is a suspicion of Congenital Megacolon.
We report a case of a year-old male patient that was admitted in the Emergency Department because of a hifschsprung megacolon that required a adkltos colectomy with ileum-rectal anastomosis. Enfermedad de Hirschsprung en adultos. With this technique an extensive dissection of the anterior wall of the rectum is avoided, thus avoiding the risk of injuring adjacent structures.
Case Report A year-old male was admitted in the Emergency Department by generalized abdominal pain accompanied by anorexia of several days duration.
Nowadays its incidence in adult is unknown as this diagnosis is often overlooked in adult population 4. J Forensic Sci ; Enfermedad de Hirschsprung en un adulto. The treatment is surgical, in order to remove the aganglionic segment and restore digestive continuity. Approximately cases have been reported in literature. Barium enema showing megarectum.
Other proposed enffrmedad include defects in the neuroblast differentiation and accelerated destruction of ganglion cells in the intestine 4.
Vólvulo en adultos
A midline laparotomy was performed, finding a massive dilatation of sigmoid colon, attaining a diameter of 44 cm at its more dilated portion.
Typically, patients go to the doctor with a long-standing history of constipation requiring frequent laxative use. Informe de um caso. Envermedad detection of enteric neurons: HD occurs in approximately 1 in live births. Enfermedad de Hirschsprung del adulto. How to cite this article. The girl was discharged on the 5th day after surgery.
Rev Argent Resid Cir, 13pp. No nausea or vomiting. Hospital Universitario Virgen Macarena. In our case, we are in a situation of irreversible dilatation of entire colon, so we opted for a total colectomy, restoring intestinal transit by ileo-rectal anastomosis.
The analytical study was normal. No abnormalities resulted from the rectal examination.
Anorectal manometry shows lack of relaxation of internal anal sphincter in response to rectal distension. Clinical features, diagnostics and treatment of Hirschsprung’s disease in adults. Enfermedad de Hirschsprung del adulto: The diagnostic is supported with studies of the barium enema, anorectal manometry and inmunohistochemestry.
Si continua navegando, consideramos que acepta su uso. There are few reports on this disease in stages after infancy in the national and international literature.
The disease predominates in females in patients above 10 years of age with a ratio of 3: CD detection of interstitial cells of Cajal: 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. The technique considered as the golden standard for the diagnosis of HD is the absence of ganglion cells in a rectal biopsy specimen.
Previous history of meningioma operated inintestinal resection in childhood unknown etiologychronic constipation, smoker of 20 cigarettes per day and moderate drinker.
The rectal biopsy should be made on the back side of rectum, about adltos cm height, and it shows absence of ganglion cells, nerve fibers hyperplasia and an increased level of acetylcholinesterase 7. Wall of the rectum with aganglionosis consistent with Hirschsprung’s disease fig. Previous article Next article. Rev Esp Enferm Dig, 3pp. The diagnosis of HD is supported by barium enema studies, anorectal manometry and rectal biopsy.
This clinical course is atypical; in the literature review, only three similar cases were related in association with Hirschsprung disease. Pathogenesis of Hirschsprung’s disease. Discussion Some authors have maintained that Hirschsprung’s disease in adults probably correspond to congenital ennfermedad not diagnosed previously, and consequently it is likely that, in fact, adult Hirschsprung’s hirschsorung does not really exist as an independent entity. Report of a case and review of the literature.
The diagnosis enfdrmedad HD in adults is much harder than in children, due to their rarity as they are often short or ultrashort aganglionic segments, which produce mild symptoms in early stages of the disease. A full-thickness biopsy was taken from the wall of the rectum, with the following findings: The treatment is surgical, removing the aganglionic segment and restoring continuity of digestive tract.
Diagnóstico tardio da doenc¸a de Hirschsprung
Treatment is always surgical. Peripheral aerial imagery was found in the dilated segment, gas-like wall, which is thickened in this segment. The absence of ganglion cells results in permanent contraction of the affected segment, preventing the passage of fecal content through that region.