Hirschsprung’s Disease Masquerading as Obstructing Congenital Band in a Premature Neonate: A Double Pathology

  • Nik Amin Sahid Nik Lah Faculty Of Medicine And Health Sciences, Universiti Malaysia Sabah, 88800 Kota Kinabalu, Sabah, Malaysia
  • Firdaus Mohd Hayati Faculty Of Medicine And Health Sciences, Universiti Malaysia Sabah, 88800 Kota Kinabalu, Sabah, Malaysia
  • Yong Guang Teh Faculty Of Medicine And Health Sciences, Universiti Malaysia Sabah, 88800 Kota Kinabalu, Sabah, Malaysia
  • Andee Dzulkarnaen Zakaria School of Medical Sciences, Hospital Universiti Sains Malaysia,16150, Kubang Kerian, Kelantan, Malaysia
Keywords: Premature Neonate, Feeding intolerance, necrotizing enterocolitis, Hirschsprung

Abstract

Chronic Feeding intolerance in preterm infants is often associated with necrotizing enterocolitis rather than Hirschsprung’s disease (HD) or intestinal obstruction due to congenital band. We report a case of a 26-day-old male born premature at 30 weeks of gestation presenting with recurrent episodes of desaturation and feeding intolerance which were initially thought to be due to NEC. However, the pathology was found to be a congenital band that caused partial intestinal obstruction and suction rectal biopsy subsequently showed it had characteristic features of HD. This dual pathology is a rare condition that required a high index of suspicion to be able to get a correct diagnosis especially in a premature baby with non-resolving chronic feeding intolerance or chronic partial obstruction.

Author Biographies

Nik Amin Sahid Nik Lah, Faculty Of Medicine And Health Sciences, Universiti Malaysia Sabah, 88800 Kota Kinabalu, Sabah, Malaysia
Head of Department, Surgery Department,
Firdaus Mohd Hayati, Faculty Of Medicine And Health Sciences, Universiti Malaysia Sabah, 88800 Kota Kinabalu, Sabah, Malaysia
Surgery Department
Yong Guang Teh, Faculty Of Medicine And Health Sciences, Universiti Malaysia Sabah, 88800 Kota Kinabalu, Sabah, Malaysia
Radiology Department
Andee Dzulkarnaen Zakaria, School of Medical Sciences, Hospital Universiti Sains Malaysia,16150, Kubang Kerian, Kelantan, Malaysia
Surgery Department

References

Sharp NE, Pettiford-Cunningham J, Shah SR, Thomas P, Juang D, Peter SDS, et al. The Prevalence of Hirschsprung Disease In Premature Infants After Suction Rectal Biopsy. Journal of Surgical Research. 2013; 184: 374-7

Lewis NA, Levitt MA, Zallen GS, Zafar MS, Iacono KL, Rossman JE, et al. Diagnosing Hirschsprung's Disease: Increasing The Odds Of A Positive Rectal Biopsy Result. Journal of Pediatric Surgery. 2003; 38: 412-6

Haricharan RN, Georgeson KE, editors. Hirschsprung disease. Seminars in Pediatric Surgery; 2008: Elsevier

Liu C, Wu T-C, Tsai H-L, Chin T, Wei C. Obstruction Of The Proximal Jejunum By An Anomalous Congenital Band—A Case Report. Journal of Pediatric Surgery. 2005; 40: E27-E9.

Published
2018-12-20