RT Journal
A1 SWENSON O, FISHER JH
T1 HIrschsprung's disease in the newborn
JF A.M.A. Archives of Surgery
JO A.M.A. Archives of Surgery
YR 1959
FD December 1
VO 79
IS 6
SP 987
OP 993
DO 10.1001/archsurg.1959.04320120129015
UL http://dx.doi.org/10.1001/archsurg.1959.04320120129015
AB Hirschsprung's disease is one of the more frequent causes of intestinal obstruction in the newborn. Improvements in the methods of diagnosis and management of patients in this group have increased the survival rate. The 3-day-old infant in Figure 1 has the signs of acute intestinal obstruction. He has become dehydrated and lethargic from fluid and electrolyte loss due to repeated bile-stained vomiting. In addition there is abdominal distension and obstipation. Many of the infants with Hirschsprung's disease present with symptoms and signs indistinguishable from other cause of intestinal obstruction such as ileal atresia. Table 1 compares the incidence of vomiting, obstipation, and abdominal distension in a group of neonates with Hirschsprung's disease and another group with ileal atresia. Figures 2 through 5 indicate the proper diagnostic methods to differentiate Hirschsprung's disease from other causes of acute intestinal obstruction in the newborn. Prompt abdominal exploration is needed in small bowel obstruction,