A Rare Case Report on Postoperative Rehabilitation in Hirschsprung Disease

Abstract

Hirschsprung disease (HD) is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the hindgut. Here, we report a case of an eight-year-old male child who had abdominal distension with a history of repetitive gas passage and a complaint of stool passage. In February 2023, the patient was diagnosed with Hirshsprung disease, for which a left-side colostomy was done. In November 2023, he underwent Hirshsprung stage 2 repair. He was operated on the 17th of December 2023 under general anaesthesia colostomy mobilization. Physiotherapy commencement and evaluation were started on the 18th of December 2023. After the colostomy procedure, the incision weakened the abdominal and lower limb muscles, while bowel obstruction and discomfort further impeded the patient's ability to perform daily activities. Physical examination revealed increased work of breathing, reduced range of motion of the bilateral hip joint, reduced muscle strength of lower limb musculature, reduced abdominal muscle strength, difficulty in walking and waddling type of gait. Physiotherapy goals were set based on the problem list. The patient showed improvement in the two weeks of physiotherapy commencement, followed by improvement in functional ability. The comprehensive care provided during the rehabilitation phase aimed at addressing the specific needs arising from the surgical intervention, promoting optimal bowel function, improving ranges and strength and ensuring overall well-being.

Effect of Pediatric Rehabilitation on Children With Viral Encephalitis: A Case Report

“…EEG measures electrical activity in the brain, helping to detect abnormal patterns or seizures. In viral encephalitis (VE), CSF typically shows elevated protein levels, nearly normal glucose levels, and mild-to-moderate mononuclear pleocytosis, primarily lymphocytic but occasionally neutrophilic, especially in the early stages [11][12][13][14]. Normal CSF white blood cell (WBC) counts in infants are higher than in adults, with a 95th percentile cutoff of no more than 19 WBCs/μL for infants under one month of age and no more than 9 WBCs/μL for infants aged one to two months.…”