Department of Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
Department of Pediatrics, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
J Med Case Rep. 2023 Jun 7;17(1):233. doi: 10.1186/s13256-023-03969-z.
Colon atresia is one of the rarest congenital anomalies of the gastrointestinal tract, with an incident range of between 1 in 10,000 and 66,000 live births. Type I colonic atresia affects only the mucosal layer of the intestine and spares the intestinal wall and mesentery. Hirschsprung Disease is a rare association of Colon atresia and is usually diagnosed as a complication of atresia treatment.
This study reports a 14-h term white middle-eastern female infant with type I transverse colonic atresia complicated by the association of Hirschsprung disease and provides a brief literature review of the topic. She presented with poor feeding, weakness, and failure to pass meconium, and her abdominal X-ray showed complete distal bowel obstruction. The presence of Hirschsprung disease was realized after complications of atresia surgery. The infant underwent a total of three surgeries involving an end-to-end anastomosis of the atresia, colostomy formation following anastomosis leakage, and Hirschsprung surgery. The patient ultimately expired.
The association between colonic atresia and Hirschsprung disease poses a diagnostic and therapeutic challenge. Considering Hirschsprung disease as a possible association in colon atresia patients can facilitate proper decision-making in the course of treating colon atresia cases and achieving better outcomes.
结肠闭锁是胃肠道最罕见的先天性异常之一,发生率为每 10000 至 66000 例活产儿中一例。I 型结肠闭锁仅影响肠黏膜层,而肠壁和肠系膜不受影响。先天性巨结肠是结肠闭锁的罕见伴发症,通常被诊断为闭锁治疗的并发症。
本研究报告了一例 14 小时龄的白种中东女性婴儿,患有 I 型横结肠闭锁,并发先天性巨结肠,并对该主题进行了简要的文献复习。患儿表现为喂养不良、虚弱和胎便排出不畅,其腹部 X 线片显示完全性远端肠阻塞。在闭锁手术后出现并发症后,才发现存在先天性巨结肠。患儿共经历了三次手术,包括闭锁的端端吻合、吻合口漏后的结肠造口术,以及先天性巨结肠手术。患儿最终死亡。
结肠闭锁与先天性巨结肠之间的关联带来了诊断和治疗方面的挑战。在治疗结肠闭锁病例时,将先天性巨结肠视为可能的关联,可以帮助做出适当的决策,从而实现更好的结局。