Ipidacrine therapy in a 1.5-month old child with Hirchprung’s disease at the postoperative period

Abstract

Introduction. Motor colon dysfunction is seen in most patients after surgical intervention for Hirschsprung’s disease regardless of the pull-through technique and absence of technical errors during surgery. The main cause of motor colon dysfunction are developed dystrophic disorders in the wall of dilated colon which can be manifested as episodes of both fecal incontinence and constipation. Cholinesterase inhibitors are pathogenetic preparations which are prescribed for hypo- and atonic colon conditions. The authors present a clinical case of successful treatment of 1.5 month-old child with Hirschsprung’s disease who was prescribed postoperative cholinesterase inhibitor Ipidacrine.Clinical case. A boy, aged one month and one day, was operated on for Hirschsprung’s disease of the recto-sigmoid form. Agangliosis sized 13 cm. Colon hypotonic dysfunction persisted in the postoperative period. Rehabilitation for 19 days did not give any positive results. So, it was decided to prescribe Ipidacrine (after approval of the Expert Commission because of age restrictions for the given preparation). Ipidacrine effective dose was 2 mg per kg twice a day per os. Therapy lasted for 7 days after which the colon function was normalized. No adverse cholinergic effects were recorded.Conclusion. The authors consider that after sufficient accumulation of clinical data Ipidacrine can be prescribed as pathogenetic preparation in functional hypotonic colon disorders in children including those with Hirschsprung’s disease at their postoperative period.