Patient Case Discussion
Case Summary
OVERVIEW
The case of a newborn was presented with concerns of bowel obstruction. The patient was transferred to NICU and underwent several surgical procedures. Biopsy results showed no ganglion cells and hypertrophic nerves, and the importance of avoiding natural healing processes and the need for reoperations in such cases was emphasized. The importance of anal dilations in preventing natural healing processes was and the need for proactive digital exams to avoid stricture formation were highlighted.
Newborn Bowel Obstruction and Stricture
The initial upper GI study was inconclusive, leading to a contrast enema that showed dilations of the bowel. The patient underwent exploratory laparotomy, creation of an ileostomy with mucus fistula, and transanal suction biopsy. Biopsy results showed no ganglion cells and no hypertrophic nerves. The patient underwent a laparoscopic-assisted Sauer's procedure at 7 months of age, with approximately 10 cm of ganglionosis. However, during rectal examination, a severe stricture was detected. The importance of avoiding natural healing processes and the need for reoperations in such cases was discussed. The patient was sent for a distal ileostogram to evaluate the colon and underwent a new anastomosis. The presenter also discussed the importance of anal dilations in preventing natural healing processes and the need for proactive digital exams to avoid stricture formation.