Differentiating Hirschsprung's Disease from other Diseases: Difference between revisions
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Hirschsprung disease must be differentiated from other diseases that cause failure to pass meconium and abdominal distension in infants, such as meconium plug syndrome, small left colon syndrome and congenital hypothyroidism. | Hirschsprung disease must be differentiated from other diseases that cause failure to pass meconium and abdominal distension in infants, such as meconium plug syndrome, small left colon syndrome and congenital hypothyroidism. | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Hirschprung's disease must be differentiated from other diseases in infancy presenting with similar features such as failure to pass meconium, abdominal | Hirschprung's disease must be differentiated from other diseases in infancy presenting with similar features such as 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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!Disease | !Disease | ||
!Prominent clinical features | !Prominent clinical features | ||
! | !Radiological findings | ||
|- | |- | ||
|Meconium plug syndrome | |Meconium plug syndrome | ||
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* Transient intestinal obstruction for 1-2 days after birth. | * Transient intestinal obstruction for 1-2 days after birth. | ||
* Obstruction is functional due to dilated colon and delayed passage of | * Obstruction is functional due to dilated colon and delayed passage of feces. | ||
* Usually seen in premature infants. | * Usually seen in premature infants. | ||
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* Reduced caliber of the colon starting from splenic flexure and going down causing intestinal obstruction. | * Reduced caliber of the colon starting from splenic flexure and going down causing intestinal obstruction. | ||
* Characterized by sudden change of the diameter of the colon. | * Characterized by a sudden change of the diameter of the colon. | ||
* Usually associated with gestational diabetes. | * Usually associated with gestational diabetes. | ||
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* Failure to pass meconium due to failure of recanalization of the intestine. | * Failure to pass meconium due to failure of recanalization of the intestine. | ||
* Proximal lesions has | * Proximal lesions has an earlier onset of symptoms than distal lesions. | ||
* Colonic atresia may affect normal children or may be associated with other abnormalities as Hirschsprung disease or gastroschisis. | * Colonic atresia may affect normal children or may be associated with other abnormalities as Hirschsprung disease or gastroschisis. | ||
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* 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, abdominal distension with or without vomiting. | * Typically presents with failure to pass meconium, abdominal distension with or without vomiting. | ||
* Meconium ileus may first present with complications perforation and | * Meconium ileus may first present with complications perforation and volvulus. | ||
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Revision as of 16:13, 15 June 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 disease must be differentiated from other diseases that cause failure to pass meconium and abdominal distension in infants, such as meconium plug syndrome, small left colon syndrome and congenital hypothyroidism.
Differential Diagnosis
Hirschprung's disease must be differentiated from other diseases in infancy presenting with similar features such as failure to pass meconium, abdominal distension and non-bilious vomiting.
- Meconium plug syndrome
- Small left colon syndrome
- Distal small bowel /colonic atresia
- Meconium ileus and cystic fibrosis complex
- Congenital hypothyroidism
Disease | Prominent clinical features | Radiological findings |
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Meconium plug syndrome |
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Small left colon syndrome |
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Distal small bowel /colonic atresia |
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Meconium ileus |
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Congenital hypothyroidism | *Most infants are born asymptomatic.
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