RESUMO
Complications of Hirschsprung's disease's surgery include the general complications of any abdominal surgery, but one of the specific complications is obstruction, which occurs in 10% of children after surgical correction and can be due to a narrowing muscular cuff or a coloanal anastomotic stenosis. We report a case of a 4-month baby, diagnosed as suffering from Hirschsprung's disease, who developed postoperative constipation after transanal endorectal pull-through due to unusual folding of the muscular cuff, which narrowed the colon. A laparoscopic approach was performed. During the surgery, it was observed that the muscular cuff was rolled down, surrounding the neorectum. The anterior rectal cuff was completely divided from the pulled-through colon. After surgery, no intraluminal stenosis was revealed on digital rectal examination. A long and tight rectal muscular cuff could be the reason for postoperative obstructive side effects. The use of laparoscopy has the advantage of confirming the suspected diagnosis and a clear visualisation of the rectal cuff. Key Words: Hirschsprung disease, Intestinal obstruction, Laparoscopy.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Doença de Hirschsprung , Obstrução Intestinal , Laparoscopia , Criança , Constrição Patológica/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Doença de Hirschsprung/complicações , Doença de Hirschsprung/cirurgia , Humanos , Lactente , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/etiologiaRESUMO
Cleidocranial Dysostosis or Dysplasia (CCD) is an infrequent clinical condition, with an autosomal dominant hereditary mode of inheritance. Triad lesions: multiple supernumerary teeth, partial or complete absence of the clavicles and open sagittal sutures and fontanelles. Nine-year-old female patient comes to our service for outpatient consultation with the main complaint of upper limbs mobility restriction with shoulders hypermotility. The chest X-ray showed partial absence of the clavicles and a cone-shaped thorax. The diagnosis of CCD was performed. Treatment of these patients requires a multidisciplinary approach which includes orthopaedic and dental corrections. The premature diagnosis allows a proper orientation for the treatment, offering a better life quality for the patient.
