DOI: https://doi.org/10.14710/dimj.v4i1.17842

Malnutrition and Developmental Delay Presenting as Complications of Late Onset Hirschprung’s disease : A Case Report

*Pujiati Pujiati  -  Department of Pediatry, Medical Faculty, Sultan Agung Islamic University, Sultan Agung Islamic Hospital, Semarang, 50164, Indonesia, Indonesia
Rudi Yuwono Raharjo  -  Department of Pediatric Surgery, Medical Faculty, Sultan Agung Islamic University, Sultan Agung Islamic Hospital, Semarang, 50164, Indonesia, Indonesia
Shafira Zahra Ovaditya  -  Department of Biomedical Science, Medical Faculty, Sultan Agung Islamic University, Sultan Agung Islamic Hospital, Semarang, 50164, Indonesia, Indonesia
Open Access Copyright (c) 2023 Diponegoro International Medical Journal
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: Hirschsprung’s Disease is a congenital disorder characterized by the absence of ganglionic cells in the colon, causing loss of peristaltic movement in the bowel. Most cases are diagnosed before the age of one and marked by the delayed passage of meconium, vomiting, and distended abdomen. Here, we present a case of a 2-year-old boy with an atypical presentation of malnutrition and developmental delay as a complication of Hirschsprung’s Disease. 

Case Presentation: A 2-year-old boy who presented with abdominal distention and chronic constipation was referred to our hospital. Past personal history revealed that he frequently suffered from the symptoms but was previously diagnosed with regular constipation and only consumed symptomatic medication. On admission, his vital signs were all normal, but his appearance was pale and weak. Growth and developmental screening showed poor growth status and developmental delay in all four domains. From the physical examination, gross abdominal distention was found and the rectal examination demonstrated a tight anal sphincter, empty rectal vault, and a green-colored stool with no forceful expulsion. Radiologic and histopathological findings suggested Hirschsprung’s disease. 

Conclusion: Chronic abdominal distention followed by malnutrition and developmental delay can present as a complication of hirschsprung’s diseasein older children. Due to these subtle signs and symptoms, a thorough examination and proper diagnostic algorithm are
Fulltext View|Download
Keywords: Hirschsprung’s disease; malnutrition; developmental delay; pediatric

Article Metrics:

Article Info
Section: Case Reports
Language : EN
Recent articles
The Difference Between Post-Laparoscopic Cystectomy Anti-Mullerian Hormone Levels In Endometrioma And Non-Endometrioma Cysts Patients The Characteristics of Eye Diseases at Merpati Eye Clinic Dr Kariadi Hospital Semarang in 2020-2022 Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) in COVID-19 patients at the RSPTN UNHAS, Makassar Malnutrition and Developmental Delay Presenting as Complications of Late Onset Hirschprung’s disease : A Case Report More recent articles
  1. Mabula JB, Kayange NM, Manyama M, Chandika AB, Rambau PF, Chalya PL. Hirschsprung’s disease in children: a five year experience at a University teaching hospital in northwestern Tanzania. BMC Res Notes. 2014 Dec;7(1):410
  2. Adamou H, Amadou Magagi I, Habou O, Adakal O, Aboulaye MB, Robnodji A, et al. Diagnosis and surgical approach of adult Hirschsprung’s disease: About two observations and review of the literature. Case series. Annals of Medicine and Surgery. 2019 Dec;48:59–64
  3. Granéli C, Dahlin E, Börjesson A, Arnbjörnsson E, Stenström P. Diagnosis, Symptoms, and Outcomes of Hirschsprung’s Disease from the Perspective of Gender. Surgery Research and Practice. 2017;2017:1–8
  4. Soussan H, Jabi R, Ouryemchi M, Haddadi Z, Bouziane M. Hirschsprung’s Disease in Adults Revealed by an Occlusive Syndrome. Cureus [Internet]. 2021 Oct 4 [cited 2023 Mar 15]; Available from: https://www.cureus.com/articles/71057-hirschsprungs-disease-in-adults-revealed-by-an-occlusive-syndrome
  5. Apte A, McKenna E, Levitt MA. Image of the Month: Decision-Making in Surgery for Late Onset Hirschsprung Disease. European J Pediatr Surg Rep. 2020 Jan;08(01):e99–101
  6. Sun X, Chu J, Li C, Deng Z. Hirschsprung’s disease presenting as intractable anemia: a report of two cases and review of the literature. BMC Pediatr. 2020 Dec;20(1):525
  7. Khandelwal N, Mandliya J, Nigam K, Patil V, Mathur A, Pathak A. Determinants of motor, language, cognitive, and global developmental delay in children with complicated severe acute malnutrition at the time of discharge: An observational study from Central India. Lazzerini M, editor. PLoS ONE. 2020 Jun 1;15(6):e0233949
  8. Wondemagegn AT, Mulu A. Effects of Nutritional Status on Neurodevelopment of Children Aged Under Five Years in East Gojjam, Northwest Ethiopia, 2021: A Community-Based Study. IJGM. 2022 Jun;Volume 15:5533–45
  9. Chattopadhyay N, Saumitra M. Developmental Outcome in Children with Malnutrition. J Nepal Paedtr Soc. 2016 Dec 31;36(2):170–7
  10. Ouladsaiad M. How to manage a late diagnosed Hirschsprung′s disease. Afr J Paediatr Surg. 2016;13(2):82

Last update:

No citation recorded.

Last update:

No citation recorded.