Contrast enema findings in patients presenting with poor functional outcome after primary repair for Hirschsprung disease
| العنوان: | Contrast enema findings in patients presenting with poor functional outcome after primary repair for Hirschsprung disease |
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| المؤلفون: | Marc A. Levitt, Steven J. Kraus, Alberto Peña, Kevin M. Garrett |
| المصدر: | Pediatric Radiology. 42:1099-1106 |
| بيانات النشر: | Springer Science and Business Media LLC, 2012. |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | Male, Reoperation, Pediatrics, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Contrast Media, Enema, Disease, Sensitivity and Specificity, digestive system, Primary repair, chemistry.chemical_compound, Radiologic Evaluation, medicine, Humans, Radiology, Nuclear Medicine and imaging, In patient, Hirschsprung Disease, Child, Neuroradiology, Contrast enema, business.industry, Infant, Reproducibility of Results, Recovery of Function, digestive system diseases, Surgery, Radiography, Barium sulfate, Treatment Outcome, chemistry, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Barium Sulfate, business, Iodine |
| الوصف: | The radiologic evaluation of Hirschsprung disease is well described in the literature. However, there is a paucity of literature describing the appearance of the neo-rectum and colon after repair, specifically describing findings in patients with poor functional outcome, which would suggest the need for reoperation.We describe findings on contrast enema and correlate them with surgical findings at reoperation in children with poor functional outcome after primary repair for Hirschsprung disease who suffer from bowel dysfunction that can manifest with either soiling or obstructive symptoms such as enterocolitis.Children were identified from our colorectal surgery database. At the time of abstract submission, 35 children had contrast enemas prior to reoperation. Additional children continue to present for evaluation. The majority of children included in the study had their primary repair performed elsewhere. The initial procedures included: Duhamel (n = 11), Soave (n = 20) or Swenson (n = 3). One child had undergone a primary Soave repair and subsequently had a Swenson-type reoperation but continued to have a poor outcome. One child's initial surgical repair could not be determined. Images were reviewed by a staff pediatric radiologist and a pediatric radiology fellow.Findings encountered on contrast enema in these children include a distal narrowed segment due to stricture or aganglionic/transitional zone segment (8), dilated/hypomotile distal segment (7), thickened presacral space due to compressing Soave cuff (11), dilated Duhamel pouch (8), active enterocolitis (3) and partially obstructing twist of the pull-through segment (1).Multiple anatomical and pathological complications exist that can lead to bowel dysfunction in children after repair of Hirschsprung disease. Little recent literature exists regarding the radiographic findings in children. We had the opportunity to review a substantial series of these children, describe the contrast enema findings in these difficult cases and correlate them with operative findings. Radiologic evaluation is key to assessing such patients; it defines the potential anatomical problem with the pull-through and facilitates surgical planning. |
| تدمد: | 1432-1998 0301-0449 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8d002aeb342bbe739a1e89ac82853247Test https://doi.org/10.1007/s00247-012-2394-2Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....8d002aeb342bbe739a1e89ac82853247 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321998 03010449 |
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