Encopresis and late diagnosis of Hirschsprung's disease in a 7-year-old boy

Abstract

Abstract:

Introduction: Encopresis is repetitive and spontaneous fecal incontinence in people older than 4 years, related to chronic constipation and dysfunction of the elimination of the fecal product, due to neurological abnormalities such as the absence of enteric neurons in the colon, Hirschsprung's disease; due to fecal impaction, the large intestine increases both in size and in length, being called Dolico megacolon. The objective is to present the clinical case of a school-age child with encopresis.

Case presentation: A 7-year-old boy presented for repetitive and spontaneous fecal incontinence associated with chronic constipation, was diagnosed by biopsy of the pectineal line, the presence of 1-2 ganglion cells was reported and treated for Hirschprung's disease. Clinical management with soft diet, polyethylene glycol, zen water, and rectal irrigations, with poor adherence; Subsequently, the descending colon, sigmoid, and rectum were excised with the Georgeson technique; postoperatively, dilations were performed with Hegar 18, and 220mg / PO / STAT metronidazole was administered due to postoperative complications. After clinical and surgical management, the patient improves by evacuating 5 times a day.

Conclusion: It is concluded that the surgical treatment was successful, however, the patient does not attend post-surgical controls; he presented himself again for the service, due to complications such as anal fissures and rectorrhagia