Author/Authors :
Hokkam, Emad Suez Canal University - Faculty of Medicine - Department of General Surgery, Egypt , Adel, Mohamed Suez Canal University - Faculty of Medicine - Department of Surgery, Egypt , El-Labban, Goda Suez Canal University - Faculty of Medicine - Department of General Surgery, Egypt , Refaat, Sherif Suez Canal University - Faculty of Medicine - Department of General Surgery, Egypt , Abou Alt, Mostafa Suez Canal University - Faculty of Medicine - Department of General Surgery, Egyp
Abstract :
Aim: The term ultra short is not clearly defined in ultrashort-segment Hirschsprung s disease. The limited extent of the ultrashort-segment Hirschsprung s disease allows for the treatment with extended sphincteromyectomy. This procedure could be diagnostic and therapeutic one. The study was designed to evaluate the role of posterior myectomy in children with refractory constipation in the diagnosis and treatment of ultrashort-segment Hirschsprung s disease. Methods: A descriptive cross sectional study was carried out among 40 pediatric patients (1 - 12 years) with refractory constipation without obvious organic causes. Detailed history, examination, barium enema and anorectal manometry were performed to all children. Posterior anorectal myectomy was performed to the studied patients. The outcome and postoperative complications were assessed for all children. Results: Agangliosis was diagnosed in 24 patients (60%) among whom constipation was improved in 75% while it was improved among (50%) of the ganglionic group. Abdominal distension, soiling and anorectal manometric studies were markedly improved after surgery in both aganglionic and ganglionic groups. Rare postoperative complications were reported among only five patients (12.5%). Conclusion: Anorectal myectomy is an effective procedure in managing refractory constipation in pediatrics and also for the diagnosis of Ultrashort segment Hirschsprung s disease and is curative in such cases
