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Date of Award

Spring 2023

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Zachary Weik

Abstract

ABSTRACT

Hirschsprung’s disease can present, rarely, with the aganglionic bowel being confined to an ultrashort-segment within the rectum. This is a case of a neonatal male who presented 1 day post birth with symptoms concerning for Hirschsprung’s disease, which was later confirmed as ultrashort-segment. Symptomatic bowel function spontaneously and periodically improved, which allowed for delays in surgery as a benefit to the patient. Approximately 4 weeks after birth, a laparoscopically assisted endorectal pull through bowel resection using the Swenson method was performed. Bowel was resected from the rectum at the level of the pelvic floor up to the rectosigmoid junction, which ends were then directly anastomosed. After 3 days of recovery and a return of spontaneous bowel function, the patient was discharged from the hospital. The bowel function persisted through the 1 week and 3 month follow up appointments, suggesting a promising outlook.

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A case of ultrashort-segment Hirschsprung's disease in a neonate

ABSTRACT

Hirschsprung’s disease can present, rarely, with the aganglionic bowel being confined to an ultrashort-segment within the rectum. This is a case of a neonatal male who presented 1 day post birth with symptoms concerning for Hirschsprung’s disease, which was later confirmed as ultrashort-segment. Symptomatic bowel function spontaneously and periodically improved, which allowed for delays in surgery as a benefit to the patient. Approximately 4 weeks after birth, a laparoscopically assisted endorectal pull through bowel resection using the Swenson method was performed. Bowel was resected from the rectum at the level of the pelvic floor up to the rectosigmoid junction, which ends were then directly anastomosed. After 3 days of recovery and a return of spontaneous bowel function, the patient was discharged from the hospital. The bowel function persisted through the 1 week and 3 month follow up appointments, suggesting a promising outlook.