Chronic bowel obstruction from colonic stenosis in early infancy-A report of two cases

Ekenze, Sebastian O.; Ezomike, Uchechukwu Obiora; Nwachukwu, Ijeoma Esther; Ariom, Anthony Ifeanyi; Emeka, Chukwubuike Kevin; Nwangwu, Emmanuel Ifeanyi; Onoh, Uchenna Sunday; Uwah, Ebere A

doi:10.4314/mmj.v31i1.14

Cited by 5 publications

(12 citation statements)

References 8 publications

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“…Sometimes, a barium enema study is not possible either due to limited availability during the emergency period or due to a poor general condition of the patient wherein it is not advisable. In our opinion, colonoscopy is one of the diagnostic tools for this condition, but sometimes, stenosis is severe such that negotiation of the scope is not possible [19], as encountered in one of our cases. However, endoscopy requires expertise and it is sometimes not possible due to the risk of complications considering the poor general condition of the patient.…”

Section: Discussionmentioning

confidence: 68%

“…Staged surgery has also been advised by various authors [12,18] but none of them emphasized ruling out HD in cases of CS. Most reported series do not favor or recommend rectal biopsy before definitive surgery for CS either primary or staged [15][16][17][18][19][20]. We strongly emphasize the role of rectal biopsy in ruling out HD in cases of acquired CS before definitive surgery.…”

Section: Discussionmentioning

confidence: 79%

“…Review of English literature revealed that the association of HD is well known with colonic atresia, but its association with acquired CS is not well reported. [15][16][17][18][19][20] We presented here 4 cases of acquired CS secondary to HD.…”

Section: Discussionmentioning

confidence: 99%

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Colonic stenosis in neonates is not always congenital or complication of necrotizing enterocolitis

Upadhyaya¹,

Mishra²,

Yusuf³

et al. 2020

J Neonatal Surg

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Background: Bowel obstruction in early infancy may results from variety of congenital anomalies involving small and large bowel. Colonic stenosis (CS) congenital or acquired is among the rare causes of chronic bowel obstructions in early infancy. Methods: Medical record of 4 patients with colonic stenosis secondary to Hirschsprung’s disease was reviewed. Results: A total of 4 cases were included in the study. Age of presentation ranged from 25 days to 96 days. Most common presentation was gross abdominal distension with visible bowel loop, vomiting, difficulty in passing stool followed by history of passing recurrent loose stools and failure to thrive. In one case there was suspicion of bowel perforation and was operated in emergency. Initial operative findings and histopathology was not suggestive of Hirschsprung’s Disease, but a full thickness rectal biopsy confirmed HD in all 4 cases. Conclusion: Hirschsprung should be considered as underlying pathology in cases of colonic stricture/stenosis in children.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 79%

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Colonic stenosis in neonates is not always congenital or complication of necrotizing enterocolitis

Upadhyaya¹,

Mishra²,

Yusuf³

et al. 2020

J Neonatal Surg

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“…[ 1 ] In literature, it has been described as a further distinct type of intestinal atresia. [ 2 ] The exact incidence of CCS has not been known. However, it had been found to constitute only 1.8%–15% of the intestinal atresias occurring in the colon.…”

Section: Introductionmentioning

confidence: 99%

Congenital Colonic Stenosis

Gupta

Singh

Sunil

et al. 2021

Journal of Indian Association of Pediatric Surgeons

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Aims: Congenital colonic stenosis (CCS) is an extremely rare cause of low-intestinal obstruction in neonates/child. We report our experience with seven cases of CCS presenting with low-intestinal obstruction and diagnosed intraoperatively and also propose an algorithm for its appropriate treatment for the adequate outcome. Materials and Methods: It was a retrospective study of seven patients of CCS including two neonates (5-days and 15-days old), four infants (age range – 2–11 months), and one 24-month-old child admitted from 2014 to 2019. Information regarding the age of presentation, clinical presentation, physical findings, radiological and laboratory findings, details of surgery, and outcome was retrieved and analyzed. Results: The male-to-female ratio was 5:2. Patients were initially diagnosed as cases of Hirschsprung's disease in five and ileal atresia in two. A final diagnosis of CCS was made during surgery and histopathological examination of resected stenotic segment. The segment involved was ascending colon in three, transverse colon in two, and sigmoid colon and junction of descending and sigmoid colon each in one patient. Resection of stenotic colonic segment and primary end-to-end anastomosis was performed in two, divided stoma after resection of the stenotic segment and secondary anastomosis in three, and proximal loop terminal ileostomy followed by resection of the stenotic colonic segment and ileocolic anastomosis after 10–12 weeks in two. Conclusions: CCS is a rare but possible cause of large-bowel obstruction, in neonatal, infant, and children particularly when associated with a history of chronic constipation since birth. It should be kept in mind as a differential diagnosis while managing a case of neonatal and pediatric intestinal obstruction, particularly low-bowel obstruction along with a history of chronic constipation. Treatment should be individualized for each patient based on clinical status and associated anomalies to give the best results with less morbidity.

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“…Universidade Federal do Triângulo Mineiro (UFTM), Uberaba -MG. *E-mail: henriqueamorims@gmail.com 2 Universidade de Franca (UNIFRAN), Franca -SP 3. Universidade Federal de Mato Grosso do Sul (UFMS), Três Lagoas -MS.…”

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Estenose de cólon transverso com realização de transversectomia: relato de caso

et al. 2020

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A obstrução intestinal ocorre devido a uma diversidade de anomalias congênitas ou adquiridas, sendo a estenose intestinal uma, embora rara, importante causa de obstrução intestinal em recém-nascidos. Contudo, o diagnóstico pode ser retardado visto que nenhum dos sintomas de maior prevalência são patognomônicos da condição e a etiologia da estenose ainda não é bem entendida. Neste trabalho, relatamos o caso de um recém-nascido do sexo feminino que apresentou, desde a primeira semana de vida, quadros recorrentes de vômitos e distensão abdominal, associados a ausência de evacuação. Inicialmente, após enema opaco, foi levantado como hipótese diagnóstica a Doença de Hirschsprung, mas após a manutenção do quadro mesmo com tratamento conservador, foi realizada laparotomia e o caso revelou-se uma estenose de transverso, sendo adotado a correção cirúrgica através da transversectomia com ileostomia e fístula cutânea protetora. Desse modo, o caso foi apresentado com a finalidade de alertar para a necessidade de se considerar os diversos diagnósticos diferenciais na elaboração do pensamento clínico e, nesse caso, a necessidade de se considerar a estenose de intestino na elaboração de diagnósticos diferenciais em lactentes com quadro de constipação crônica.

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Chronic bowel obstruction from colonic stenosis in early infancy-A report of two cases

Cited by 5 publications

References 8 publications

Colonic stenosis in neonates is not always congenital or complication of necrotizing enterocolitis

Colonic stenosis in neonates is not always congenital or complication of necrotizing enterocolitis

Congenital Colonic Stenosis

Estenose de cólon transverso com realização de transversectomia: relato de caso

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