Difference between revisions of "Hirschsprung's disease"

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**Enterocolitis: distention, bowel wall thickening
 
**Enterocolitis: distention, bowel wall thickening
 
**Obstruction: air fluid levels
 
**Obstruction: air fluid levels
 +
*Barium/contrast enema will show narrowed colon and dilated intestine above
 +
**Sensitivity 70% and specificity of 83%
 
*Diagnosis requires rectal biopsy (consult GI)
 
*Diagnosis requires rectal biopsy (consult GI)
  

Revision as of 14:21, 17 August 2016

Background

  • Congenital aganglionosis of colon
    • Usually rectosigmoid area
      • Short segment affects rectum and small amount of distal colon
      • Long segment affects more of colon, proximal intestine
    • Rarely involves more proximal intestine
  • 30% associated with a syndrome
  • 1:5,000 live births

Clinical Features

Differential Diagnosis

Infant Constipation

Evaluation

  • KUB distended colon, empty rectum
    • Enterocolitis: distention, bowel wall thickening
    • Obstruction: air fluid levels
  • Barium/contrast enema will show narrowed colon and dilated intestine above
    • Sensitivity 70% and specificity of 83%
  • Diagnosis requires rectal biopsy (consult GI)

Management

  • Consult pediatric surgeon for operative management
  • Treat enterocolitis with broad spectrum antibiotics

Disposition

  • Admit if symptoms of obstruction, enterocolitis

See Also

External Links

References