Differentiating Hirschsprung's Disease from other Diseases: Difference between revisions
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==Overview== | ==Overview== | ||
Hirschsprung's disease must be differentiated from other diseases that cause failure to pass [[meconium]] or [[abdominal distension]] in infants, | Hirschsprung's disease must be differentiated from other diseases that cause a failure to pass [[meconium]] or [[abdominal distension]] in infants, including [[meconium plug syndrome]], [[small left colon syndrome]], and [[congenital hypothyroidism]]. | ||
== | ==Differentiating Hirschsprung's disease from other diseases== | ||
Hirschsprung's disease must be differentiated from other diseases in infancy | Hirschsprung's disease must be differentiated from other diseases in infancy such as the following that present with similar features, including a failure to pass [[meconium]], [[abdominal distension]], and non-bilious vomiting. | ||
*[[Meconium plug syndrome]] | *[[Meconium plug syndrome]] | ||
*[[Small left colon syndrome]] | *[[Small left colon syndrome]] | ||
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* Failure to pass [[meconium]] due to failure of intestine recanalization. | * Failure to pass [[meconium]] due to failure of intestine recanalization. | ||
* Proximal lesions | * Proximal [[lesions]] have an earlier onset of symptoms than distal [[lesions]]. | ||
* [[Intestinal atresia|Colonic atresia]] may affect normal children or may be associated with other abnormalities as Hirschsprung's disease or [[gastroschisis]].<ref name="pmid17077911">{{cite journal |vauthors=Spitz L |title=Observations on the origin of congenital intestinal atresia |journal=S. Afr. Med. J. |volume=96 |issue=9 Pt 2 |pages=864 |year=2006 |pmid=17077911 |doi= |url=}}</ref> | * [[Intestinal atresia|Colonic atresia]] may affect normal children or may be associated with other abnormalities as Hirschsprung's disease or [[gastroschisis]].<ref name="pmid17077911">{{cite journal |vauthors=Spitz L |title=Observations on the origin of congenital intestinal atresia |journal=S. Afr. Med. J. |volume=96 |issue=9 Pt 2 |pages=864 |year=2006 |pmid=17077911 |doi= |url=}}</ref> | ||
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* [[Intestinal obstruction]] due to inspissation of [[meconium]] in the [[Ileum|distal ileum]]. | * [[Intestinal obstruction]] due to inspissation of [[meconium]] in the [[Ileum|distal ileum]]. | ||
* Most cases of [[meconium ileus]] are secondary to [[cystic fibrosis]]. | * Most cases of [[meconium ileus]] are secondary to [[cystic fibrosis]]. | ||
* Typically presents with failure to pass [[meconium]] | * Typically presents with failure to pass [[meconium]] and [[abdominal distension]] with or without [[vomiting]]. | ||
* [[Meconium ileus]] may first present with complications, | * [[Meconium ileus]] may first present with complications, including [[perforation]] and [[volvulus]].<ref name="pmid14237408">{{cite journal |vauthors=HOLSCLAW DS, ECKSTEIN HB, NIXON HH |title=MECONIUM ILEUS. A 20-YEAR REVIEW OF 109 CASES |journal=Am. J. Dis. Child. |volume=109 |issue= |pages=101–13 |year=1965 |pmid=14237408 |doi= |url=}}</ref> | ||
|[[Image:Meconium-ileus-neonate-with-cystic-fibrosis - Case courtesy of Dr Michael Sargent, Radiopaedia.org, rID 6009.jpg|center|300px|thumb|Contrast enema shows inspissated meconium starting from the mid-sigmoid colon and going up till the splenic flexure. The colon is normal in diameter, ruling out microcolon]] | |[[Image:Meconium-ileus-neonate-with-cystic-fibrosis - Case courtesy of Dr Michael Sargent, Radiopaedia.org, rID 6009.jpg|center|300px|thumb|Contrast enema shows inspissated meconium starting from the mid-sigmoid colon and going up till the splenic flexure. The colon is normal in diameter, ruling out microcolon - Case courtesy of Dr Michael Sargent, Radiopaedia.org, rID 6009]] | ||
|- | |- | ||
|[[Congenital hypothyroidism]] | |[[Congenital hypothyroidism]] | ||
| | |||
*[[Macroglossia]] | *Most infants are born [[asymptomatic]].<ref name="pmid2295961">{{cite journal |vauthors= |title=Elementary school performance of children with congenital hypothyroidism. New England Congenital Hypothyroidism Collaborative |journal=J. Pediatr. |volume=116 |issue=1 |pages=27–32 |year=1990 |pmid=2295961 |doi= |url=}}</ref> | ||
*Hoarse cry | *Symptoms, if present, may include, but not limited to: | ||
*[[Umbilical hernia]] | **[[Macroglossia]] | ||
*Puffy facies | **Hoarse cry | ||
*Increased head circumference | **[[Umbilical hernia]] | ||
*[[Hypothermia]] | **Puffy facies | ||
**Increased head circumference | |||
**[[Hypothermia]] | |||
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Latest revision as of 14:39, 10 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
Hirschsprung's disease must be differentiated from other diseases that cause a failure to pass meconium or abdominal distension in infants, including meconium plug syndrome, small left colon syndrome, and congenital hypothyroidism.
Differentiating Hirschsprung's disease from other diseases
Hirschsprung's disease must be differentiated from other diseases in infancy such as the following that present with similar features, including a failure to pass meconium, abdominal distension, and non-bilious vomiting.
- Meconium plug syndrome
- Small left colon syndrome
- Distal small intestine/colon atresia
- Meconium ileus and cystic fibrosis complex
| Disease | Prominent clinical features | Radiological findings |
|---|---|---|
| Meconium plug syndrome |
|
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| Small left colon syndrome |
|
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| Distal small intestine/colon atresia |
|
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| Meconium ileus |
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| Congenital hypothyroidism |
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References
- ↑ Keckler SJ, St Peter SD, Spilde TL, Tsao K, Ostlie DJ, Holcomb GW, Snyder CL (2008). "Current significance of meconium plug syndrome". J. Pediatr. Surg. 43 (5): 896–8. doi:10.1016/j.jpedsurg.2007.12.035. PMC 3086204. PMID 18485962.
- ↑ Berdon WE, Slovis TL, Campbell JB, Baker DH, Haller JO (1977). "Neonatal small left colon syndrome: its relationship with aganglionosis and meconium plug syndrome". Radiology. 125 (2): 457–62. doi:10.1148/125.2.457. PMID 910057.
- ↑ Spitz L (2006). "Observations on the origin of congenital intestinal atresia". S. Afr. Med. J. 96 (9 Pt 2): 864. PMID 17077911.
- ↑ HOLSCLAW DS, ECKSTEIN HB, NIXON HH (1965). "MECONIUM ILEUS. A 20-YEAR REVIEW OF 109 CASES". Am. J. Dis. Child. 109: 101–13. PMID 14237408.
- ↑ "Elementary school performance of children with congenital hypothyroidism. New England Congenital Hypothyroidism Collaborative". J. Pediatr. 116 (1): 27–32. 1990. PMID 2295961.