RT Book, Section
A1 Teitelbaum, Daniel H.
A1 Wulkan, Mark L.
A1 Georgeson, Keith E.
A1 Langer, Jacob C.
A2 Ziegler, Moritz M.
A2 Azizkhan, Richard G.
A2 Allmen, Daniel von
A2 Weber, Thomas R.
SR Print(0)
ID 1100434630
T1 Hirschsprung Disease
T2 Operative Pediatric Surgery, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-162723-8
LK accesssurgery.mhmedical.com/content.aspx?aid=1100434630
RD 2024/04/19
AB Diagnoses  are  typically  made  with  suction  rectal  biopsy,  however,  when  a  full-thickness  biopsy  is  needed,  it  is  important  to  carefully  determine  your  distance  from  the  dentate  line.  This  insures  an  accurate  ruling  in  or  out  of  Hirschsprung  disease.A  colostomy  may  be  needed  in  those  with  severe  enterocolitis  or  those  with  a  delayed  diagnosis  and  very  dilated  colon.  In  those  cases,  a  laparoscopic  inspection  of  the  abdomen  can  often  facilitate  the  identification  of  the  transition  zone,  and  placement  of  the  initial  incision  (see  later  in  chapter  for  laparoscopic  leveling  biopsies).The  decision  to  perform  an  open  versus  laparoscopic-assisted  or  transanal  pull-through  probably  does  not  affect  the  long-term  results  of  the  infant.  Thus,  the  approach  that  the  surgeon  is  most  familiar  with  should  be  selected.For  total  colonic  Hirschsprung  disease  either  a  standard  Duhamel  or  endorectal  pull-through  is  acceptable,  and  associated  with  similar  outcomes.