Download PDF
CC BY 4.0 · European J Pediatr Surg Rep. 2020; 08(01): e95-e98
DOI: 10.1055/s-0040-1717128
Case Report

A Hirschsprung Pull-through, “with a Twist”

Hira Ahmad
1   Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio, United States
,
Devin R. Halleran
1   Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio, United States
,
Raquel Quintanilla
1   Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio, United States
,
Alessandra C. Gasior
1   Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio, United States
,
Richard J. Wood
1   Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio, United States
,
Marc A. Levitt
1   Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio, United States
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Hirschsprung disease is the most common neurocristopathy in children, resulting in the congenital loss of enteric ganglia. Surgery, which involves resecting the aganglionic segment and restoring bowel continuity, usually results in a good outcome; however, some patients suffer from multiple episodes of enterocolitis and other obstructive symptoms. A contrast enema, examination under anesthesia, and rectal biopsy can identify the cause of obstruction in many cases, including a rare explanation, a twist of the pull-through, a case of which we present here.

Keywords

Hirschsprung disease - pull-through reoperation - twisted pull-through - enterocolitis - congenital intestinal obstruction


Publication History

Received: 20 April 2020

Accepted: 18 August 2020

Article published online:
09 January 2021

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Pratap A, Gupta DK, Shakya VC. et al. Analysis of problems, complications, avoidance and management with transanal pull-through for Hirschsprung disease. J Pediatr Surg 2007; 42 (11) 1869-1876
    CrossrefPubMedGoogle Scholar
  • 2 Swenson O. Early history of the therapy of Hirschsprung's disease: facts and personal observations over 50 years. J Pediatr Surg 1996; 31 (08) 1003-1008
    CrossrefPubMedGoogle Scholar
  • 3 De La Torre L, Langer JC. Transanal endorectal pull-through for Hirschsprung disease: technique, controversies, pearls, pitfalls, and an organized approach to the management of postoperative obstructive symptoms. Semin Pediatr Surg 2010; 19 (02) 96-106
    CrossrefPubMedGoogle Scholar
  • 4 Langer JC. Repeat pull-through surgery for complicated Hirschsprung's disease: indications, techniques, and results. J Pediatr Surg 1999; 34 (07) 1136-1141
    CrossrefPubMedGoogle Scholar
  • 5 Levitt MA, Dickie B, Peña A. Evaluation and treatment of the patient with Hirschsprung disease who is not doing well after a pull-through procedure. Semin Pediatr Surg 2010; 19 (02) 146-153
    CrossrefPubMedGoogle Scholar
  • 6 Langer JC, Rollins MD, Levitt M. et al. American Pediatric Surgical Association Hirschsprung Disease Interest Group. Guidelines for the management of postoperative obstructive symptoms in children with Hirschsprung disease. Pediatr Surg Int 2017; 33 (05) 523-526
    CrossrefPubMedGoogle Scholar
  • 7 Peña A, Elicevik M, Levitt MA. Reoperations in Hirschsprung disease. J Pediatr Surg 2007; 42 (06) 1008-1013 , discussion 1013–1014
    CrossrefPubMedGoogle Scholar
  • 8 Zaslavsky C, Loening-Baucke V. Anorectal manometric evaluation of children and adolescents postsurgery for Hirschsprung's disease. J Pediatr Surg 2003; 38 (02) 191-195
    CrossrefPubMedGoogle Scholar
  • 9 Keshtgar AS, Ward HC, Clayden GS, de Sousa NM. Investigations for incontinence and constipation after surgery for Hirschsprung's disease in children. Pediatr Surg Int 2003; 19 (1-2): 4-8
    CrossrefPubMedGoogle Scholar
  • 10 Martin MJ, Steele SR, Noel JM, Weichmann D, Azarow KS. Total colonic manometry as a guide for surgical management of functional colonic obstruction: Preliminary results. J Pediatr Surg 2001; 36 (12) 1757-1763
    CrossrefPubMedGoogle Scholar
  • 11 Tang ST, Wang GB, Cao GQ. et al. 10 years of experience with laparoscopic-assisted endorectal Soave pull-through procedure for Hirschsprung's disease in China. J Laparoendosc Adv Surg Tech A 2012; 22 (03) 280-284
    CrossrefPubMedGoogle Scholar
  • 12 Garrett KM, Levitt MA, Peña A, Kraus SJ. Contrast enema findings in patients presenting with poor functional outcome after primary repair for Hirschsprung disease. Pediatr Radiol 2012; 42 (09) 1099-1106
    CrossrefPubMedGoogle Scholar