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[Pseudo-"isolated" intestinal perforation in a very low birth weight infant: exceptional presentation of Hirschsprung's disease].

Abstract
Intestinal perforations in preterm newborn are characterized with high morbidity and mortality rates. They often are associated with necrotizing enterocolitis and seldom correspond to idiopathic spontaneous intestinal perforation. Perforations upstream of an intestinal organic obstruction (atresia), or of a functionnal obstruction (meconium-ileus, Hirschsprung disease) have been considered to be rare in preterm newborns. We report a case of caecal perforation with a pneumoperitoneum which occurred at 5 days of life, in a 28-week gestational age infant, that was treated by cecostomy. There were no signs of necrotizing enterocolitis. At 43 days of life, the preoperative contrast enema study revealed a left colon transition zone, suggesting a Hirschsprung disease, which was confirmed by rectal biopsies. Transanal pull-through was performed. There were no postoperative complication. This case demonstrates that an isolated intestinal perforation in very preterm newborn can reveal a Hirschsprung disease, especially if it occurs in the caecum.
AuthorsS Courvoisier, C Piolat, C Durand, F Cneude, P Andrini, C Jacquier, T Debillon, J-F Dyon
JournalArchives de pediatrie : organe officiel de la Societe francaise de pediatrie (Arch Pediatr) Vol. 13 Issue 10 Pg. 1320-2 (Oct 2006) ISSN: 0929-693X [Print] France
Vernacular TitlePerforation intestinale du grand prématuré en apparence "isolée": mode de révélation exceptionnel de la maladie de Hirschsprung.
PMID16919428 (Publication Type: Case Reports, English Abstract, Journal Article)
Topics
  • Cecum (injuries, surgery)
  • Hirschsprung Disease (diagnosis, surgery)
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases (diagnosis, surgery)
  • Infant, Very Low Birth Weight
  • Intestinal Perforation (etiology, surgery)
  • Male

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