Hirschsprung disease and Appendicitis in pediatric patient: case report

Abstract

Hirschsprung’s disease is a malformation of the enteric nervous system, characterized by a lack of ganglion cells in the submucosal plexus and myenteric in the colon distal wall. The rectum-sigma is affected only in the 80% of cases, however, cases of total aganglio- nosis can be found.

Case Report: A 4 year old male pre-school from La Iguala, Lempira, Honduras, with constipation and abdominal distention evolution history of two years of evolution, which has progressively worsened, and was attenuated with the use of enemas every two day to be able to defecate. In May 2016, he arrived at the Mario Catarino Rivas Hospital, where he underwent an emergency exploratory laparotomy due to the presence of clinical deterioration due to constipation and abdominal distention, accompanied by vomi- ting with food remains and a high fever of one week of evolution. In this surgery, a left partial colectomy and a therapeutic colostomy were done, besides, Hirschsprung’s disease was diagnosed by biopsy and the incidental finding of appendicitis, for which an appendectomy was also done, obtaining generally a satisfactory evolution. generally a satisfactory evolution. The histopathological study of the rectal biopsy is the gold standard for the diagnosis. The absence of ganglion cells in the submucosal plexus with he- matoxylin and eosin staining establishes the diagnosis. The treatment of Hirschsprung’s disease is surgical and the removal of the affected colonic segment is sought, so that an anastomosis of the proximal and distal colon to the aganglionic area can beachieved.