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Nat Rev Dis Primers ; 9(1): 54, 2023 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-37828049

RESUMEN

Hirschsprung disease (HSCR) is a rare congenital intestinal disease that occurs in 1 in 5,000 live births. HSCR is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the intestine. Most patients present during the neonatal period with the first meconium passage delayed beyond 24 h, abdominal distension and vomiting. Syndromes associated with HSCR include trisomy 21, Mowat-Wilson syndrome, congenital central hypoventilation syndrome, Shah-Waardenburg syndrome and cartilage-hair hypoplasia. Multiple putative genes are involved in familial and isolated HSCR, of which the most common are the RET proto-oncogene and EDNRB. Diagnosis consists of visualization of a transition zone on contrast enema and confirmation via rectal biopsy. HSCR is typically managed by surgical removal of the aganglionic bowel and reconstruction of the intestinal tract by connecting the normally innervated bowel down to the anus while preserving normal sphincter function. Several procedures, namely Swenson, Soave and Duhamel procedures, can be undertaken and may include a laparoscopically assisted approach. Short-term and long-term comorbidities include persistent obstructive symptoms, enterocolitis and soiling. Continued research and innovation to better understand disease mechanisms holds promise for developing novel techniques for diagnosis and therapy, and improving outcomes in patients.


Asunto(s)
Síndrome de Down , Enfermedad de Hirschsprung , Discapacidad Intelectual , Síndrome de Waardenburg , Recién Nacido , Humanos , Enfermedad de Hirschsprung/diagnóstico , Enfermedad de Hirschsprung/genética , Enfermedad de Hirschsprung/patología , Síndrome de Down/complicaciones , Síndrome de Waardenburg/complicaciones , Canal Anal , Discapacidad Intelectual/complicaciones
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