Abstract
BackgroundAlthough uncommon and seldom experienced, intestinal perforation is a well-known complication of Hirschsprung’s disease (HD). A literature review revealed that the cecum, including the appendiceal base, is a site of perforation. The cecum is not suitable for making an ordinary loop colostomy, and the optimal operative strategy remains to be established.Case presentationWe present a combination technique composed of tangential cecostomy at the perforated portion and postoperative care with a transanal indwelling tube, which was used in the treatment of a 3-day-old boy with cecal perforation with long-segment Hirschsprung’s disease. A temporary simple blowhole stoma and continuous decompression with daily irrigation via a transanal indwelling tube in the distal colon achieved a secure recovery and was followed by a definitive operation in the early period. The combination of tangential cecostomy and transanal indwelling catheter management led to the preservation of the ileocecal valve.ConclusionsWe review the Japanese literature and emphasize the usefulness of this combination technique by blowhole tangential cecostomy and transanal tube insertion for neonatal cecal perforation in patients with HD in today’s early definitive operation era.
Highlights
Uncommon and seldom experienced, intestinal perforation is a well-known complication of Hirschsprung’s disease (HD)
We review the Japanese literature and emphasize the usefulness of this combination technique by blowhole tangential cecostomy and transanal tube insertion for neonatal cecal perforation in patients with HD in today’s early definitive operation era
The cecum appears to be unsuitable for making an ordinary loop colostomy; the optimal operative strategy remains to be established
Summary
The incidence of neonatal gastrointestinal perforation in patients with HD is thought to be decreasing. 2. Newman B, Nussbaum A, Kirkpatric JA Jr. Bowel perforation in Hirschsprung’s disease. Preoperative colonic decompression and irrigation through a transanal tube to perform the onestage pull-through procedure for Hirschsprung’s disease. A new method of transanal catheter fixation for neonates with long segment-type Hirschsprung’s disease. 7. Mochizuki K, Shinkai M, Kitagawa N, Take H, Usui H, Hosokawa T, et al Continuous transanal decompression for infants with long- and total-type Hirschsprung’s diseases as a bridge to curative surgery: a single-center experience. Evolution in the management of Hirschsprung’s disease in the UK and Ireland: a national survey of practice revisited. Primary laparoscopic pull-through for Hirschsprung’s disease in infants and children. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
