Hirschsprung Disease Flashcards

1
Q

which part of the intestine does hirschsprung disease usually occur

A

large intestine

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2
Q

the absence of what causes this disease

A

ganglion cells

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3
Q

what is the result of no ganglion cells

A

obstruction
accumulation of intestinal contents
distention of bowel

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4
Q

what are signs of this disease in the newborn

A

no meconium within 24-48 hours
refusal to feed
bilious vomiting
abdominal distention

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5
Q

what are signs of this disease in the infant

A

failure to thrive
constipation
explosive V/D
fever

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6
Q

what are signs of this disease in the child

A

constipation
ribbon-like stools
visible peristalsis
palpable fecal mass LLQ

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7
Q

what does an abdominal xray show

A

dilated loops of bowel

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8
Q

what does an unprepped barium enema show

A

visualize the dilated & narrow segments of the colon

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9
Q

what is the definitive test that reveals the absence of ganglion cells

A

rectal biopsy

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10
Q

what are 3 alternatives to surgery

A

dietary modifications
stool softeners
isotonic irrigations

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11
Q

how often would isotonic irrigations need to be done

A

daily

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12
Q

when should enemas be avoided

why

A

suspect enterocolotis

potential for perforation

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13
Q

what are the 2 phases of surgical management

A

temporary colostomy

close colostomy

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14
Q

at which weight can the colostomy be closed

A

20 lbs

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15
Q

what kind of diet is needed pre-op

A

high calorie
high protein
low fiber

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16
Q

what are s/s of bowel perforation

A

abdominal pain

fever

17
Q

what are 4 post-op complications

A

chronic constipation
anal stricture
incontinence
enterocolitis

18
Q

which % develop enterocolitis post-op

A

20-60

19
Q

what results from enterocolitis

A

ischemia & ulceration of the bowel

20
Q

what are s/s of enterocolitis

A

bleeding & diarrhea