Tatekawa Yukihiro
Department of Pediatric Surgery, Saku Central Hospital Advanced Care Center, Nagano 385-0051, Japan.
J Surg Case Rep. 2021 Sep 8;2021(9):rjab390. doi: 10.1093/jscr/rjab390. eCollection 2021 Sep.
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.
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。