Long-term outcome of neonates with suspected Hirschsprung's disease, but normal rectal biopsy.
Eur J Gastroenterol Hepatol
; 28(8): 917-22, 2016 Aug.
Article
en En
| MEDLINE
| ID: mdl-27097357
ABSTRACT
BACKGROUND AND OBJECTIVES:
Hirschsprung's disease (HD) must always be considered in very early-onset constipation. Although HD has a well-described clinical course, little is known about those neonates in whom HD was excluded. We aimed to describe the long-term clinical outcomes of neonates with a clinical suspicion of HD that was excluded by rectal suction biopsy.METHODS:
This is a single-center double-cohort comparative study. Neonates who underwent rectal mucosa biopsy for suspected HD were age and sex matched with healthy controls. A survey on clinical outcomes, stooling patterns, and other gastrointestinal (GI)-related conditions was sent to parents. Pathology slides were re-reported by an experienced histopathologist blinded to the clinical data.RESULTS:
A total of 51 neonates were included [25 cases, 26 controls; 41% males, median time of follow-up 4.25 years (interquartile range 2.7-6.9)]. Nine (36%) of patients in the case group required prolonged laxative use for constipation during the first year of life compared with 0 (0%) controls (P<0.001). This difference was maintained at the end of follow-up, with 5 (20%) versus 0 (0%), respectively (P=0.02). Case neonates were significantly more likely to be hospitalized or to be diagnosed with a chronic GI-related condition than the controls (33 vs. 12%, P=0.01; and 19 vs. 8%, P=0.04, respectively).CONCLUSION:
Neonatal constipation is associated with long-term GI-related disorders and should be considered clinically significant even when the diagnosis of HD is excluded. Neonates with early-onset abnormal stooling patterns should be monitored with adequate pediatrician or pediatric gastroenterologist follow-up.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Recto
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Estreñimiento
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Defecación
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Enfermedad de Hirschsprung
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Mucosa Intestinal
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Child
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Child, preschool
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Female
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Humans
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Infant
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Male
/
Newborn
País/Región como asunto:
Asia
Idioma:
En
Año:
2016
Tipo del documento:
Article