Hirschsprung Disease
Protocols
Clinical Features:
- 1)Chronic constipation not respond medical treatment.
- 2)Stool- small,pillet,Ribon like.
- 3)Enterocolitis
- 4)H/O delayed passage meconium
- 5)Abdominal distension, billious vomiting
O/E:
- P/R- easily pass figure but feel strong grip.& Rectum empty when out finger small fees & gas discharge.
Investigation:
- 1) plan X-ray abdomen : distended guts
- 2) Unprepared bowel with contrast enema:
- proximal dilated segment
- Narrow lower colon
- Rectal diameter less then sigmoid colon -HPD
- 3)Rectal Suction biposy: Absence of ganglionic cell
- 4)Rectal manometry
Rx:
In Acute conditions
- NPO
- NG Tube- to decompression stomach
- Antibiotic (inj.Ciprofloxacin / ceftriaxone)
- Rectal irregation with normal saline
- KT inj. If need
Definative treatment : surgery
1st step:
- Colostomy
2nd step:
- Resection of aganglionic part & end to end anastomosis
3rd step:
- Colostomy closure
Now a days Single stage procedure most popular.
Prognosis: good if treated early