Fang Shu,Huang Zhaowei,Zhao Xiaoxia,et al.Association of congenital intestinal atresia and Hirschsprung’s disease: five new cases and its diagnosis and treatment[J].Journal of Clinical Pediatric Surgery,,22():822-826.[doi:10.3760/cma.j.cn101785-202305044-005]
Association of congenital intestinal atresia and Hirschsprung’s disease: five new cases and its diagnosis and treatment
- Abstract:
- Objective To summarize the clinical characteristics of congenital intestinal atresia (CIA) complicating Hirschsprung’s disease (HD) and review its diagnostic and surgical experiences.Methods From May 2016 to August 2021,5 children were diagnosed as CIA combined with HD at Children’s Hospital of Zhejiang University School of Medicine.Retrospective review was conducted for the relevant clinical data.Laparotomy was performed for intestinal obstruction.There were ileal atresia (n=4) and ascending colon atresia (n=1).Two children of ileal atresia underwent atresia intestinal resection with primary anastomosis.Another 2 children of ileal atresia and 1 child of colonic atresia underwent atresia intestinal resection and enterostomy.Results Two children of primary anastomosis underwent a second laparotomy for postoperative intestinal obstruction.Enterostomy was performed for patent anastomosis and microcolon.An association of HD was confirmed by multiple biopsies of distal intestine.Two children of ileal atresia and enterostomy showed abnormal barium enema and both were diagnosed as HD after rectal biopsy.One child of ascending colonic atresia was diagnosed as HD by intraoperative sigmoid biopsy and rectal biopsy.After modified Swenson procedure,all of them survived and recovered well.Total colonic HD (n=3),total intestinal aganglionosis (n=1) and long segment HD (n=1) were confirmed.Conclusion Identification of colonic morphology,length of sigmoid and intestinal biopsy are essential for surgical correction of intestinal atresia.For lowering the possibility of laparotomy,enterostomy is recommended when colonic function is in doubt.Barium enema and rectal biopsy are important tools for ascertaining the morphologies and functions of colon.
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Memo
收稿日期:2023-5-26。
基金项目:国家自然科学基金面上项目(82171699);浙江省自然科学基金(LY21H150005)
通讯作者:钭金法,Email:toujinfa@zju.edu.cn