Hirschsprung's disease (HD) is clearly a childhood disease, as it is the most common cause of bowel obstruction in newborns and children, but it is uncommon in adults, leaving it untreated or misdiagnosed.
The goal of this series of 12 HD cases is to investigate the clinical aspects of this disease, define diagnostic signals, and evaluate different therapy options.
Materials and Methods: A total of 12 patients with acute intestinal obstruction were referred to our department by the emergency department of the HABIB THAMEUR hospital in Tunis.
A lateral discharge colostomy was present in ten of them.
Following perforation of the sigmoid colon, one patient had a peritoneal lavage and a Hartman colostomy for stercoral (faecal) peritonitis.
For a stercoral peritonitis caused by a perforation of the left colon, one patient received a peritoneal lavage and the Bouilly Wolkman double stomy.
Only 25% of the cases were subjected to anorectal manometry. It demonstrated that none of the patients had a recto-anal inhibitory reflex (RAIR).
Histology of rectum and colon specimens is used to provide a definitive diagnosis. In two cases, the disease spread to the rectum and sigmoid colon, but in the other ten, it was limited to the rectum.
In all patients, surgical resection of the recto-colic junction with coloanal anastomosis and a protective right lateral ileostomy was used. The diagnosis of HD was confirmed by histology of the surgical material.
Hirschsprung's illness is uncommon in adults, but it is not unheard of. In young people with a history of chronic constipation, it should be considered. First and foremost, the diagnosis is clinical. We don't need to use histology to confirm the diagnosis when the barium enema appearances are pathognomonic. RAIR is frequently not visible on anorectal manometry.
The most common treatment for HD in adults is surgical resection.
Author(s) Details:
Haithem Zaafouri,
Department of General Surgery, Habib Thameur Hospital Tunis, Tunisia.
Wassim Riahi,
Department of General Surgery, Habib Thameur Hospital Tunis, Tunisia.
Manel Mabrouk,
Department of Medical Oncology, Habib Bouguatefa Hospital Bizerte, Tunisia.
Mouna Cherif,
Department of General Surgery, Habib Thameur Hospital Tunis, Tunisia.
Fatma Khanchal,
Department of Pathological Anatomy and Cytology, Habib Thameur Hospital
Tunis, Tunisia.
Nizar Khedhiri,
Department of General Surgery, Habib
Thameur Hospital Tunis, Tunisia.
Dhafer Haddad,
Department of General Surgery, Habib Thameur Hospital Tunis, Tunisia.
Anis Ben Maamer,
Department of General Surgery, Habib Thameur Hospital Tunis, Tunisia.
Please see the link here: https://stm.bookpi.org/ETDHR-V4/article/view/6053
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