Long-segment Hirschsprung's disease

Arch Surg. 1992 Sep;127(9):1047-50; discussion 1050-1. doi: 10.1001/archsurg.1992.01420090051008.

Abstract

We identified 21 children (14 boys and seven girls) with long-segment Hirschsprung's disease defined as aganglionosis extending proximal to the ileocecal valve. Long-segment Hirschsprung's disease is difficult to diagnose and treat; symptoms may be mild, and diagnosis delayed. Abdominal distention and constipation or delayed passage of meconium are the most common symptoms. Radiologic studies are unreliable in establishing the diagnosis. The morbidity rate is high because of the high transition zone and short gut. The long-term outcome of patients after the standard Duhamel procedure is satisfactory, except with extremely high transition zones. Pull-through procedures should not be performed in the small infant, but should be delayed until patients are old enough to be continent.

MeSH terms

  • Abdomen / pathology
  • Constipation / physiopathology
  • Female
  • Follow-Up Studies
  • Hirschsprung Disease / pathology
  • Hirschsprung Disease / physiopathology
  • Hirschsprung Disease / surgery*
  • Humans
  • Ileal Diseases / pathology
  • Ileal Diseases / physiopathology
  • Ileal Diseases / surgery
  • Ileocecal Valve / pathology
  • Ileostomy / adverse effects
  • Ileostomy / methods
  • Infant
  • Infant, Newborn
  • Male
  • Meconium
  • Survival Rate
  • Vomiting / physiopathology