Dilemma of Pull-through Long Segment Hirschsprung Disease

Case Summary

This case reviewed the past medical history of the patient that developed progressive abdominal distention with refusal of feedings during first week of life. Patient underwent additional abdominal exploration. Multiple biopsies confirmed a diagnosis of Hirschsprung Disease with ganglionated proximal stoima. The team considered including surgical options such as a stomach pull through or a pancolectomy and decided to proceed with surgery and a stomach pull through, believing that contrast studies might not be as beneficial. During the operation, they performed right side colonic mobilization with an anticlockwise rotation. They also addressed potential complications and emphasized the importance of caution during this procedure.