Division of Long Residual Spur after Duhamel's Pull through with Endo-GIA Stapler under Colonoscopic Guidance

Mandelia, Ankur; Sharma, Moinak Sen; Siddiqui, Yousuf; Mishra, Ashwani Kumar

doi:10.4103/jiaps.jiaps_281_20

Cited by 2 publications

(2 citation statements)

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“…In similar fashion obstructive symptoms post Duhamel may be associated with a spur, or dilatation of the aganglionic segment, which will require surgical excision. [69][70][71]…”

Section: Tight Rectal Cuffmentioning

confidence: 99%

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Hirschsprung's disease. Management

Morera,

Nurko

2024

Aliment Pharmacol Ther

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SummaryBackgroundHirschsprung's disease (HD) is a rare congenital disease that is characterised by the absence of ganglion cells in the myenteric plexus starting in the distal bowel. This results in distal functional obstruction and may lead to complications like enterocolitis. The treatment is surgical and requires the resection of the aganglionic segment, and the pull‐through of normal intestine into the anal opening. However, even after successful surgery, patients may continue to have symptoms.AimDiscuss current surgical techniques and management strategies for patients with postoperative symptoms after surgical correction of Hirschsprung's disease.MethodsA review of the literature was done through PubMed, with a focus on clinical management and approach.ResultsWe describe the clinical problems that can occur after surgical correction. These include obstructive symptoms, enterocolitis, or faecal incontinence. A systematic approach for the evaluation of these patients includes the exclusion of anatomic, inflammatory, behavioural or motility related factors. Depending on the severity of the symptoms, the evaluation includes examination under anaesthesia, the performance of contrast studies, endoscopic studies, measurement of anal sphincter function and colonic motility studies. The treatment is focused towards addressing the different pathophysiological mechanisms, and may include medical management, botulinum toxin to the anal sphincter or rarely redo‐operation.ConclusionsPatients with Hirschsprung's disease need to have surgical correction, and their postoperative long‐term management is complex given a variety of associated problems that can occur after surgery. A systematic evaluation is necessary to provide appropriate therapy.

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“…In similar fashion obstructive symptoms post Duhamel may be associated with a spur, or dilatation of the aganglionic segment, which will require surgical excision. [69][70][71]…”

Section: Tight Rectal Cuffmentioning

confidence: 99%

“…In the case of Yancy‐Soave procedure, a tight muscular cuff can produce obstructive symptoms requiring redo pull‐through or dividing the cuff. In similar fashion obstructive symptoms post Duhamel may be associated with a spur, or dilatation of the aganglionic segment, which will require surgical excision 69–71 …”

Section: Obstructive Symptomsmentioning

confidence: 99%