Management of Recurrent Enterocolitis Following Soave’s Pull-Through in a Child With Hirschsprung’s Disease: Value of Botox Injections

Kashif Chauhan, Gulwish Moghul, Shailinder Singh

Abstract


Recurrent enterocolitis (RE) is a common problem following Soave’s pull-through for Hirschsprung’s disease. The main cause of this is outlet obstruction. This can be anatomical (stricture, stenosis, and twist of bowel) or histological (aganglionic or transition zone pull through). Outlet obstruction leading to RE can be from two factors that are specific to Soave’s pull through: hypertonicity of the internal anal sphincter or residual cuff. A residual cuff can be managed through excision of the cuff, although this is a major surgical undertaking. We report a successful use of Botox in a child with RE secondary to residual cuff following primary laparoscopic Soave’s operation. A Botox injection was administered under general anesthesia at five separate sittings. This case demonstrates that repeated Botox injections can be a valuable alternative to colostomy, excision of residual cuff or a redo pull-through when a cuff is thought to be responsible for RE.




J Med Cases. 2017;8(1):29-32
doi: https://doi.org/10.14740/jmc2720w

Keywords


Hirschsprung’s disease; Soave pull-through; Enterocolitis; Anal sphincter; Botox

Full Text: HTML PDF
 

Browse  Journals  

 

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

 

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

 

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

 

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

 

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 
       
 

Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.journalmc.org   editorial contact: editor@journalmc.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.