When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Hirschsprung disease

Última revisão: 13 Feb 2025
Última atualização: 21 Jan 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • vomiting
  • explosive passage of stool/gas
  • abdominal distension
  • delayed passage of meconium
  • faltering growth
  • chronic constipation
Detalhes completos

Outros fatores diagnósticos

  • fever
  • diarrhea
  • bloody stool
  • abdominal tenderness
  • septic shock
  • cecal or appendiceal perforation
  • meconium plug syndrome
Detalhes completos

Fatores de risco

  • Down syndrome
  • male sex
  • family history
  • Shan-Waardenburg syndrome
  • Mowat-Wilson syndrome
  • Haddad syndrome
  • multiple endocrine neoplasia type 2 (MEN2)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • plain abdominal x-ray
  • contrast enema
Detalhes completos

Investigações a serem consideradas

  • rectal biopsy
  • anorectal manometry
Detalhes completos

Algoritmo de tratamento

AGUDA

short-segment/long-segment disease: without enterocolitis

short-segment/long-segment disease: with enterocolitis

total colonic aganglionosis

Colaboradores

Autores

Lily S. Cheng, MD

Assistant Professor

University of Virginia

Charlottesville

VA

Declarações

LSC is the co-author of a reference cited in this topic.

Kristy Lynn Rialon, MD

Associate Professor of Surgery

Division of Pediatric Surgery

Texas Children’s Hospital

Baylor College of Medicine

Houston

TX

Declarações

KLR declares that she has no competing interests.

Agradecimentos

Dr Lily S. Cheng and Dr Kristy Lynn Rialon would like to gratefully acknowledge Dr Andrea Bischoff and Dr Alberto Peña, the previous contributors to this topic. AB and AP are co-authors of several references cited in this topic.

Revisores

Ivo de Blaauw, MD, PHD

Pediatric Surgeon

Radboud University Nijmegen

Academic Medical Center

Nijmegen

Netherlands

Declarações

IdB declares that he has no competing interests.

Jose Manuel Tovilla, MD

Colorectal Pediatric Surgeon

Chief of the Colorectal Clinic

Hospital Infantil de Mexico Federico Gomez

Mexico

Declarações

JMT declares that he has no competing interests.

Daniel P. Doody, MD

Pediatric Surgeon

Department of Pediatric Surgery

Massachusetts General Hospital

Boston

MA

Declarações

DPD declares that he has no competing interests.

  • Hirschsprung disease images
  • Diagnósticos diferenciais

    • Meconium-plug syndrome
    • Cystic fibrosis (meconium ileus)
    • Small left colon syndrome
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Management and outcomes for long-segment Hirschsprung disease: a systematic review from the APSA outcomes and evidence based practice committee
    • Guidelines for the diagnosis and management of Hirschsprung-associated enterocolitis
    Mais Diretrizes
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal