Hirschsprung's disease in young adults
Hirschsprung's disease is rarely seen in the young adult, and presents unique problems in management because of the massive dilatation and hypertrophy that occur proximal to the aganglionic rectum or the rectosigmoid colon. The diagnosis, which may be suspected by barium enema, is confirmed by...
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| Veröffentlicht in: | The American journal of surgery 1986, Vol.151 (1), p.104-109 |
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| container_title | The American journal of surgery |
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| creator | Starling, James R. Croom, Robert D. Thomas, Colin G. |
| description | Hirschsprung's disease is rarely seen in the young adult, and presents unique problems in management because of the massive dilatation and hypertrophy that occur proximal to the aganglionic rectum or the rectosigmoid colon. The diagnosis, which may be suspected by barium enema, is confirmed by suction or full-thickness biopsy of the rectum that may be complemented by anal manometry. Based on our experience with eight patients, a two-stage surgical reconstruction is recommended, with a preliminary sigmoid colostomy through the normally innervated colon and an associated defunctionalized stoma constituting the initial operation. The distal colonic stoma permits cleansing of the caudal colon while the normally innervated proximal colon reverts to near normal caliber, usually within 2 to 6 months. This approach is in accord with the recommendation of Fairgrieve [2]. Reconstruction using a Duhamel or Soave procedure has given good results. The Duhamel procedure seems preferable when a considerable discrepancy remains between the ganglionic and aganglionic segments of rectum [4]. |
| doi_str_mv | 10.1016/0002-9610(86)90019-X |
| format | Article |
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The diagnosis, which may be suspected by barium enema, is confirmed by suction or full-thickness biopsy of the rectum that may be complemented by anal manometry. Based on our experience with eight patients, a two-stage surgical reconstruction is recommended, with a preliminary sigmoid colostomy through the normally innervated colon and an associated defunctionalized stoma constituting the initial operation. The distal colonic stoma permits cleansing of the caudal colon while the normally innervated proximal colon reverts to near normal caliber, usually within 2 to 6 months. This approach is in accord with the recommendation of Fairgrieve [2]. Reconstruction using a Duhamel or Soave procedure has given good results. 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The diagnosis, which may be suspected by barium enema, is confirmed by suction or full-thickness biopsy of the rectum that may be complemented by anal manometry. Based on our experience with eight patients, a two-stage surgical reconstruction is recommended, with a preliminary sigmoid colostomy through the normally innervated colon and an associated defunctionalized stoma constituting the initial operation. The distal colonic stoma permits cleansing of the caudal colon while the normally innervated proximal colon reverts to near normal caliber, usually within 2 to 6 months. This approach is in accord with the recommendation of Fairgrieve [2]. Reconstruction using a Duhamel or Soave procedure has given good results. The Duhamel procedure seems preferable when a considerable discrepancy remains between the ganglionic and aganglionic segments of rectum [4].</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Colostomy</subject><subject>Constipation - diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hirschsprung Disease - diagnosis</subject><subject>Hirschsprung Disease - surgery</subject><subject>Humans</subject><subject>Intestinal Obstruction - diagnosis</subject><subject>Male</subject><subject>Malformations</subject><subject>Manometry</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Rectum - innervation</subject><subject>Rectum - surgery</subject><subject>Reoperation</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1986</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEFLw0AQhRdRaq3-A4UepOohuptNNpuLIEWtUPCi0NuymczqSprUnUbovze1oUdPw8x87zHzGDsX_FZwoe4453GUK8GvtbrJORd5tDhgQ6GzPBJay0M23CPH7IToq2uFSOSADWSeqCwRQzaZ-UDwSavQ1h9XNC49oSUc-3q8abrR2JZttaZTduRsRXjW1xF7f3p8m86i-evzy_RhHoHUah0lUurExc5qmUpeFLkABSpGjEFL5VKty0xmCUCZCOsAU4laOEhL6YpUApcjNtn5rkLz3SKtzdITYFXZGpuWTKZUruJMdWCyAyE0RAGdWQW_tGFjBDfbeMz2d7P93Whl_uIxi0520fu3xRLLvajPo9tf9ntLYCsXbA2e9pjOJJfxFrvfYdhl8eMxGAKPNWDpA8LalI3__45fSwh_uw</recordid><startdate>1986</startdate><enddate>1986</enddate><creator>Starling, James R.</creator><creator>Croom, Robert D.</creator><creator>Thomas, Colin G.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1986</creationdate><title>Hirschsprung's disease in young adults</title><author>Starling, James R. ; Croom, Robert D. ; Thomas, Colin G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-43384f2fa83530bb91c6c62ee2c836f588d7374ccd41afce53e81fc5d3fb53c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1986</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Colostomy</topic><topic>Constipation - diagnosis</topic><topic>Diagnosis, Differential</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hirschsprung Disease - diagnosis</topic><topic>Hirschsprung Disease - surgery</topic><topic>Humans</topic><topic>Intestinal Obstruction - diagnosis</topic><topic>Male</topic><topic>Malformations</topic><topic>Manometry</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Rectum - innervation</topic><topic>Rectum - surgery</topic><topic>Reoperation</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Starling, James R.</creatorcontrib><creatorcontrib>Croom, Robert D.</creatorcontrib><creatorcontrib>Thomas, Colin G.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Starling, James R.</au><au>Croom, Robert D.</au><au>Thomas, Colin G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hirschsprung's disease in young adults</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>1986</date><risdate>1986</risdate><volume>151</volume><issue>1</issue><spage>104</spage><epage>109</epage><pages>104-109</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Hirschsprung's disease is rarely seen in the young adult, and presents unique problems in management because of the massive dilatation and hypertrophy that occur proximal to the aganglionic rectum or the rectosigmoid colon. The diagnosis, which may be suspected by barium enema, is confirmed by suction or full-thickness biopsy of the rectum that may be complemented by anal manometry. Based on our experience with eight patients, a two-stage surgical reconstruction is recommended, with a preliminary sigmoid colostomy through the normally innervated colon and an associated defunctionalized stoma constituting the initial operation. The distal colonic stoma permits cleansing of the caudal colon while the normally innervated proximal colon reverts to near normal caliber, usually within 2 to 6 months. This approach is in accord with the recommendation of Fairgrieve [2]. Reconstruction using a Duhamel or Soave procedure has given good results. The Duhamel procedure seems preferable when a considerable discrepancy remains between the ganglionic and aganglionic segments of rectum [4].</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>3946741</pmid><doi>10.1016/0002-9610(86)90019-X</doi><tpages>6</tpages></addata></record> |
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| ispartof | The American journal of surgery, 1986, Vol.151 (1), p.104-109 |
| issn | 0002-9610 1879-1883 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adolescent Adult Biological and medical sciences Colostomy Constipation - diagnosis Diagnosis, Differential Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Hirschsprung Disease - diagnosis Hirschsprung Disease - surgery Humans Intestinal Obstruction - diagnosis Male Malformations Manometry Medical sciences Methods Rectum - innervation Rectum - surgery Reoperation Stomach. Duodenum. Small intestine. Colon. Rectum. Anus |
| title | Hirschsprung's disease in young adults |
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