Hirschsprung's disease in the newborn
dc.contributor.author | Polley, Theodore Z. | en_US |
dc.contributor.author | Coran, Arnold G. | en_US |
dc.date.accessioned | 2006-09-11T18:38:32Z | |
dc.date.available | 2006-09-11T18:38:32Z | |
dc.date.issued | 1986-06 | en_US |
dc.identifier.citation | Polley, Theodore Z.; Coran, Arnold G.; (1986). "Hirschsprung's disease in the newborn." Pediatric Surgery International 1(2): 80-83. <http://hdl.handle.net/2027.42/47145> | en_US |
dc.identifier.issn | 0179-0358 | en_US |
dc.identifier.issn | 1437-9813 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/47145 | |
dc.description.abstract | The records of all patients with Hirschsprung's disease diagnosed and treated at our institution between 1 July 1974 and 31 August 1985 were reviewed. Of these 99 patients, 35 (35%) presented and were diagnosed within the first 30 days of life and constitute the basis of the present study group. Twenty-two infants (63%) had standard rectosigmoid disease with a male-to-female ratio of 2.2:1. Only one infant was premature. The spectrum of presenting signs included abdominal distension in 19 (54%), failure to pass meconium within the first 48 h of life in 16 (46%), “constipation” in 12 (34%), and vomiting in 9 (26%). Intestinal perforation was a presenting sign in 2 patients (6%) and enterocolitis occurred preoperatively in 4 (12%). Evaluation was facilitated by diagnostic barium enema in 60% of the patients. In those infants able to undergo elective evaluation, the definitive diagnosis was made by suction rectal biopsy, which was accurate in all cases. In addition to the high proportion of patients with long-segment disease (13 patients, 37%), there was a significant incidence of associated congenital anomalies (26%), including Down's syndrome in 5 (14%). Thirty-three of the 35 patients have undergone definitive treatment using the endorectal pull-through procedure, performed at an average age of 12 months, with no mortality related to the operation. In addition to highlighting the high incidence of congenital anomalies, the large proportion of neonates with long-segment disease, and the reliability of the diagnostic barium enema, this subgroup of patients with Hirschsprung's disease emphasizes the special diagnostic and management considerations required in the newborn infant who presents with sepsis of unknown etiology, intestinal obstruction, or constipation. A high index of suspicion, liberal use of suction rectal biopsy, early leveling colostomy, and definitive treatment by endorectal pull-through are important in achieving 0% operative mortality and excellent functional results. | en_US |
dc.format.extent | 409580 bytes | |
dc.format.extent | 3115 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Springer-Verlag; Springer-Verlag Berlin Heidelberg | en_US |
dc.subject.other | Surgery | en_US |
dc.subject.other | Pediatric Surgery | en_US |
dc.subject.other | Pediatrics | en_US |
dc.subject.other | Newborn | en_US |
dc.subject.other | Hirschsprung's Disease | en_US |
dc.subject.other | Bowel Obstruction Newborn | en_US |
dc.subject.other | Medicine & Public Health | en_US |
dc.title | Hirschsprung's disease in the newborn | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Pediatrics | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Section of Pediatric Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA; Mott Children's Hospital, Ann Arbor, Michigan, USA; Mott Children's Hospital, Room F7516, Box 066, 48109, Ann Arbor, MI, USA | en_US |
dc.contributor.affiliationum | Section of Pediatric Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationumcampus | Ann Arbor | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/47145/1/383_2004_Article_BF00166865.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1007/BF00166865 | en_US |
dc.identifier.source | Pediatric Surgery International | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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