Neonatal functional intestinal obstruction and the presence of severely immature ganglion cells on rectal biopsy: 6 year experience
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Tariq Burki • Liina Kiho • Irene Scheimberg • Simon Phelps • Devesh Misra • Harry Ward • Isabel Colmenero
- چاپ و سال / کشور: 2011
Description
Purpose We report our experience of managing eight babies who presented with neonatal intestinal obstruction and whose rectal biopsies showed severely immature ganglion cells. Methods Neonatal unit records were reviewed to detect patients with suspected Hirschsprung’s disease or functional intestinal obstruction. Those with intestinal atresia, anorectal malformation, malrotation, cystic fibrosis and prematurity were excluded. Results We identified 73 patients born at term. Twentyseven did not need a rectal biopsy. Twenty-one had biopsy proven Hirschsprung’s disease, while 17 had a normal rectal biopsy. Eight patients, all of whom presented with severe abdominal distension, showed immature ganglion cells. Seven had failed to pass meconium after birth. X-rays in all patients showed distended loops of bowel. Two neonates underwent an emergency laparotomy and a stoma. A repeat biopsy at 3 months showed maturation of ganglion cells and the stoma was reversed. Rectal biopsy was repeated in two other patients 2–9 months after the first biopsy and showed mature ganglion cells. At follow-up, one patient still suffers from severe constipation. Seven are asymptomatic now, including the two patients who needed a stoma. Conclusion Immature ganglion cells on rectal biopsy may be an indicator of transient functional immaturity of the intestine.
Pediatr Surg Int (2011) 27:487–490 DOI 10.1007/s00383-010-2850-8 Published online: 23 January 2011
