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.

Author: Tugal Vijin
Country: Dominican Republic
Language: English (Spanish)
Genre: Politics
Published (Last): 2 May 2016
Pages: 241
PDF File Size: 8.43 Mb
ePub File Size: 3.26 Mb
ISBN: 924-3-49949-632-6
Downloads: 63793
Price: Free* [*Free Regsitration Required]
Uploader: Kikasa

The disease predominates in females in patients above 10 years of age with a ratio of 3: A year-old male was admitted in the Emergency Department by generalized abdominal pain accompanied by anorexia of several days duration.

The infrequency of this diagnosis in this hirschdprung and the clinical course of this patient underscore the uniqueness of this case.

Clinical case Female patient, 13 years old, coming from Campo Grande – MS, reports that since birth had intestinal constipation, with mean bowel movements at every days with hardened feces, being followed-up by a pediatrician and in treatment for functional constipation.

Enfermedad de Hirschprung del adulto

The Congenital Megacolon presents agonglionosis in different lengths of the intestine; many times associated to other congenital anomalies. Myomectomy has the advantage of being technically easier and presenting a low morbidity, but it has worse functional outcomes and can only be used in ultra-HD 7,8.

Rectum had a normal size. Niger J Clin Pract.

General laboratory tests were performed complete blood count, blood chemistry, and TSH and the results were enferrmedad the normal ranges. Abdomen was very distended and tympanic, with previous laparotomy scar, painful on palpation diffusely. Imaging studies such as computed tomography CT and barium enemas are usually accepted for evaluation of chronic constipation, which is a common disorder in adults.

Vólvulo en adultos

Barium enema showing megarectum. It is important to consider the presence of this rare pathologic process in young adult patients with treatment-refractory chronic constipation, in whom other more common diseases have been ruled out through easily accessed studies, such as imaging or anorectal physiology studies. Print Send to a friend Export reference Mendeley Statistics. We report a case of a year-old male patient that was admitted in the Emergency Department because of a massive megacolon that required a total colectomy with ileum-rectal anastomosis.


Cirugía en la enfermedad de Hirschsprung del adulto

It should be emphasized that the hirschsprugn segment is strictured. Introduction Hirschsprung’s disease HD is a malformation of the large intestine characterized by the absence of ganglion cells enfermmedad submucosal and myenteric plexus, which produces a functional obstruction and dilatation proximal to the affected segment 1.

Rev Col Gastroenterol, 22pp. Then, normal colon is lowered through the aganglionic segment, making an anastomosis at level of Morgagni columns. Diagnosis requires imaging and rectal manometry and confirmation by histopathology.

Symptoms had worsened in recent months, prompting her to seek the evaluation of a proctologist. However, post-operative bowel functioning is not always satisfactory. As in our case, it may rarely occur as massive colonic dilatation with risk of perforation, which requires emergency surgery. Hirschsprung’s disease is characterized by absence of ganglion cells in submucosal and myenteric plexus of distal bowel.

It usually presents as severe constipation with colonic dilatation proximal to the aganglionic segment. The rectal biopsy should be made on the back side of rectum, enfemredad 6 cm height, and it shows absence of ganglion cells, nerve fibers hyperplasia and an increased level of acetylcholinesterase 7.

Given the low incidence of HD in adults, it is difficult to compare different procedures. Therefore, wnfermedad most liquid stools upstream pass around the fecal impaction and produce the engermedad symptom, known as fecal incontinence soiling.

In addition, the reported symptoms caused the girl’s parents to begin to justify such a fact as a result of some psychological, rather than organic, disorder. The most important exam to diagnose this disease efnermedad the rectal biopsy of the complete stenotic segment, which shows the absence of ganglion cells, nerve hypertrophy presence and incresement of the activity of acetycholinesterase.


SRJ is a prestige metric based on the idea that not all citations are the same. Then we proceed to perform a resection and anastomosis between healthy colon and anal mucosa.

SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal’s impact. Under a Creative Commons license. Chromogranin detection of neuroendocrine cells: It is a rare disease in adulthood, but its diagnosis should be considered in cases of constipation that is refractory to conventional medical therapy. Only cases of HD have been described in adults, with male predominance in a 4: This segment is everted and extracted by transanal way.

Laboratory studies revealed leukocytosis with left deviation and elevated C-reactive protein. These radiological images were consistent with Hirschsprung’s disease; for this reason, we extracted surgically the fecal mass through the anus. In addition, it is established that factors related to gender play a role, since men are preferentially affected, at a frequency of 4: 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.

Its pages are open to the members of the Association, as well as to all members of the medical community interested in using this forum to publish their articles in accordance with the journal editorial policies.

The diagnostic is supported with studies of the barium enema, anorectal manometry and inmunohistochemestry.