Diagnosticul şi tratamentul megacolonului congenital la nou-născuţi

Abstract

Hirschsprung’s disease is one of the most common causes of intestinal obstruction in the neonate. The treatment of this condition and its life-threatening complications (such as necrotizing enterocolitis) are challenging. The purpose of this study is to evaluate the early and late results of classical surgical treatment in a cohort of 97 cases operated on in the Paediatric Surgery Department. Of the 53 cases, 20 had low gestational weight (less than 2500 g). The diagnosis was established at the age less than a month in 52 cases, up to one year in 19 cases, up to three years in 7 cases, up to 3 years in 9 cases and beyond 6 years in 10 cases. The diagnosis methods comprised clinical exam, X-Ray studies (plain radiography, barium enema) and colonic biopsy in all cases. The results of surgical treatment were appreciated in terms of continence, number of stools per day, tonus of the external and internal sphincters, and social insertion. The Duhamel technique had 88% good results. The authors conclude that the classical approach to Hirschsprung disease gives good continence and social insertion to the patients.