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一例慢性便秘患者服用聚乙二醇电解质溶液后发现的超短段先天性巨结肠病例。

A case of ultrashort-segment Hirschsprung's disease discovered after taking polyethylene glycol electrolyte solution for chronic constipation.

作者信息

Tatekawa Yukihiro

机构信息

Department of Pediatric Surgery, Saku Central Hospital Advanced Care Center, Nagano 385-0051, Japan.

出版信息

J Surg Case Rep. 2021 Sep 8;2021(9):rjab390. doi: 10.1093/jscr/rjab390. eCollection 2021 Sep.

Abstract

We report a case of ultrashort-segment Hirschsprung's disease (HD) involving a 4-year-old girl. She was born at 29 weeks gestation from a twin pregnancy. She weighed 1013 g. After birth, she received glycerin enemas and sodium picosulfate hydrate to facilitate defecation. She passed stool once every 4-5 days. When she was 4 years old, she was medicated with polyethylene glycol electrolyte solution. After she drank the solution twice, the abdomen distended rapidly without passage of stool. An abdominal X-ray showed a stored stool mass and a barium enema study revealed dilatation from the rectum to the sigmoid colon due to the stool mass. She underwent anorectal manometry and a rectal biopsy, and was suspected to have HD. She underwent a Soave endorectal pull-through with an oblique anastomosis. She passed stool 4-10 times a day for 6 months postoperatively, but the frequency of passing stool gradually deceased without medications.

摘要

我们报告一例超短段型先天性巨结肠(HD)病例,患者为一名4岁女童。她是孕29周出生的双胎之一,出生体重1013克。出生后,她接受了甘油灌肠剂和水合匹可硫酸钠以促进排便,每4至5天排便一次。4岁时,她使用聚乙二醇电解质溶液进行治疗。在饮用该溶液两次后,她的腹部迅速膨胀且未排便。腹部X线显示有储存的粪便团块,钡剂灌肠检查显示因粪便团块导致从直肠到乙状结肠扩张。她接受了肛门直肠测压和直肠活检,怀疑患有HD。她接受了Soave经肛门拖出术并进行了斜行吻合。术后6个月,她每天排便4至10次,但在未用药的情况下,排便频率逐渐降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc2a/8427879/ddf10d4d2cbe/rjab390f1.jpg

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