Redo transanal pull-through for Hirschsprung's disease
Epublication WebSurg.com, Nov 2011;11(11). URL: http://websurg.com/doi/vd01en3439
We present a case of a 3-year-old boy with a history of Hirschsprung’s Disease. He had been diagnosed at the age of two, and at that time underwent a laparoscopic-assisted Soave pull-through. He initially did well, but after a few months, had recurrent severe constipation with fecal impaction as well as an episode of enterocolitis. A contrast enema showed a dilated distal pull-through segment with normal-caliber sigmoid colon proximally, and an EUA found a preserved dentate line circumferentially with a stricture at the previous anastomosis. A biopsy was performed two centimeters proximal to the anastomosis and pathology was consistent with transition zone bowel with hypertrophic nerves and only occasional ganglion cells. We decided to do a redo transanal pull-through to remove the aganglionated and dilated segment of colon.