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Colonic Perforation in a Nursing Infant as the Initial Presentation of Hirschsprung’s Disease. Is There a Relation with Prokinetics Use? - Abstract

Nestor Martínez Salcedo, Paulino Martinez Hernandez-Magro,Claudia Robledo Monterrubio

 

Abstract

Perforation is a rare initial presentation in Hirschsprung’s disease. Early diagnosis and treatment are a challenge for the surgeon. A possible relation with the use of prokinetics should be studied. We present the case of a female infant, 50 days old, with constipation from birth treated with cisapride and trimebutine that subsequently developed irritability, bloating and vomiting. Plain abdominal X-ray revealed intra-abdominal free air and dilated bowel loops. She underwent exploratory laparotomy finding generalized purulent peritonitis, with small abscess in pelvic cavity and punctiform single sigmoid perforation. Partial colectomy and colostomy was performed. Prokinetics could contribute to the development of perforation in Hirshsprung’s disease, further work is required to examine whether the risk of perforation is increased in patients with Hirshsprung’s disease who are treated with prokinetics.

Keywords: bowel perforation, Hirschsprung’s disease, prokinetics

 

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