Assistência de enfermagem aplicada à criança com estomia decorrente da Doença de Hirschprung / Nursing care applied to children with an ostomy arising from Hirschsprung's Disease / Cuidados de enfermería aplicada al niño con ostomía generada por la Enfermedad de Hirschprung

Objetivo: relatar o caso de uma criança com estomia decorrente da doença de Hirschprung por meio da sistematização da assistência de enfermagem, utilizando a Classificação Internacional para a Prática de Enfermagem (CIPE®). Método: estudo descritivo e observacional, do tipo caso clínico. Para auxiliar a elaboração dos diagnósticos utilizou-se como estratégia o software CMap Tools (mapa conceitual) em sua versão 6.01. Resultados: os diagnósticos de enfermagem identificados foram: Incontinência Intestinal; Integridade Corporal Comprometida na Criança; Processo (colostomia) comprometido; Susceptibilidade para infecção; Aderência parcial à bolsa de colostomia; Cólica abdominal; Status social comprometido; Ansiedade atual pela cirurgia. Conclusão: observa-se que os diagnósticos de enfermagem estão relacionados, principalmente, às alterações orgânicas acarretadas pela doença crônica e pelo aspecto social intrínseco à colostomia do escolar.(AU)

Objective: to report the case of a child with an ostomy resulting from Hirschsprung's disease through the systematization of nursing care, using the International Classification for Nursing Practice (ICNP®). Method: descriptive and observational clinical case study. To assist the development of diagnostic was used as the strategy CMap Tools software (concept map) version 6.01. Results: the nursing diagnoses identified were: Intestinal incontinence; Body integrity Committed in Children; Process (colostomy) committed; Susceptibility to infection; Partial adherence to the colostomy bag; Abdominal cramping; Compromised social status; Current anxiety from surgery. Conclusion: it is observed that the nursing diagnoses are mainly related to the organic changes entailed by the chronic disease and by the intrinsic social aspect the colostomy of school.(AU)

Objetivo: relatar el caso de un niño con estomía causada por la enfermedad de Hirschprung, a través de la sistematización de la asistencia de enfermería, utilizando la Clasificación Internacional para la Práctica de Enfermería (CIPE®). Método: estudio descriptivo y observacional, del tipo caso clínico. Para ayudar a elaborar los diagnósticos se utilizó como estrategia el software CMap Tools (mapa conceptual) en su versión 6.01. Resultados: los diagnósticos que se identificaron de enfermería son: incontinencia intestinal; integridad corporal comprometida en el niño; proceso (colostomía) comprometido; susceptibilidad para infección; adherencia parcial a la bolsa de colostomía; cólico abdominal; status social comprometido; ansiedad actual por la cirugía. Conclusión: se observa que los diagnósticos de enfermería se relacionan, principalmente, con las alteraciones orgánicas causadas por la enfermedad crónica y por el aspecto social intrínseco a la colostomía del estudiante.(AU)

Nursing Intervention for Outpatient Rehabilitation in Pediatric Patients with Hirschsprung Disease after Colectomy.

OBJECTIVE: The present study was designed to evaluate the effectiveness of a nursing intervention program for outpatient rehabilitation of children with Hirschsprung-associated enterocolitis (HAEC) after radical colectomy for Hirschsprung disease (HD). BACKGROUND: Postoperative outcomes severely affect the quality of life in pediatric HD patients after operation. The improvement in defecation function is regarded as one of the most useful parameters to evaluate the quality of life in HD patients after radical intestinal resection. A close attention should also be paid to the patients' ability of social adaptation. METHODS: This prospective, randomized control trial enrolled 85 pediatric patients with HAEC after colectomy. They were randomly divided into the control and intervention groups. All the patients were followed up for 6 to 12 months after initial HAEC treatment. RESULTS: The intervention group had a lower enterocolitis recurrence rate than the control group, with a better ability to control defecation and their parents had better rehabilitation nursing knowledge (p < 0.05). The degree of parents' satisfaction regarding the outcome was significantly better in the intervention group than that in the control group (p < 0.05). CONCLUSION: A systemic rehabilitation nursing program could decrease enterocolitis recurrence, improve the recovery of anorectal functions, and enhance the quality of life in the pediatric patients after radical colectomy.

Laparoscopic Swenson pull-through procedure for congenital megacolon.

Constipation that is unresponsive to conventional remedies is the primary symptom of congenital megacolon (ie, Hirschsprung's disease). The cause of congenital megacolon is lack of ganglion cells in the bowel. The laparoscopic Swenson pull-through procedure involves removing the aganglionic segment of the colon, bringing the normally decompressed bowel through the pelvic floor, and anastomosing the bowel to the anorectal verge. Advantages of the laparoscopic approach include shorter lengths of hospital stay and fewer complications resulting from disruption of skin integrity.

Differential diagnosis: a case study.

Health care professionals who care for neonates must be able to recognize early signs/symptoms that suggest acute illness. Such early recognition and appropriate management may improve outcome. This article presents a case study and permits the reader to evaluate data and make decisions about diagnoses and treatment. Current research-based approaches to management are also discussed.

Estudio cuantitativo de la denervación de los plexos nerviosos en el megacolon chagásico / Annual reports 1994 / Quantitative study of neural plexuses denervation in chagasic megacolon

El megacolon chagásico es la patología digestiva más frecuente observada en nuestro país en la etapa crónica de la enfermedad de Chagas. La destrucción de las células ganglionares del plexo mientérico por el Trypanosoma cruzi es considerada como la lesión inicial. Para determinar el grado y la distribución de la aganglionosis e hipoganglionosis de los plexos de Meissner y de Auerbach según la proporción células/mm, se analizaron histológicamente segmentos de megacolon de 10 pacientes adultos con serología positiva para Chagas. Todos los segmentos presentaron áreas de aganglionosis e hipoganglionosis severa de distribución multifocal a lo largo de los mismos, más acentuadas en el plexo de Auerbach y tambien en el extremo distal y en el tercio distal del segmento. (o a 0.17 células ganglionares por mm.), sin displasia neuronal. La lesión neuronal observada en el megacolon chagásico es multifocal y diseminada, y su mayor severidad en la zona rectosigmoidea se relacionaría con transtornos fisiológicos en la coordinación motora

Hirschsprung disease in infants and children.

Hirschsprung disease (HD) is a disorder of motility in the bowel caused by the absence of parasympathetic ganglion cells. This article will discuss the symptoms, diagnostic tests, methods of surgical management and complications of HD with an emphasis on enterocolitis. HD is a treatable condition and with proper management, the child can return to a normal life.