Gacor – Hirschsprung’s disease is a congenital congenital disorder caused by failure of the neurodevelopmental process in the intestine. In the period of fetal development, normally, nerve growth starts from head to toe (cranio-caudal migration). However, during the fourth to seventh weeks, the developing neural ganglia fail to migrate. As a result, there are some segments of the intestine that do not have ganglionic nerves.
The segment that lacks a nerve ganglion is called the aganglionic segment and extends proximally from the rectum. The aganglionic segment of the intestine of a Hirschsprung patient cannot relax. This causes the stool to be retained, even unable to be excreted. Therefore, the sufferer’s stomach tends to look distended or enlarged. When a rectal touch or digital rectal examination is performed, the patient’s stool also often spurts. In addition, as mentioned above, this disease occurs due to genetic factors, but it is multifactorial in nature because there are certain genes that are known to contribute, especially the RET and EDNRB genes.
This disease can be detected by paying attention to when meconium comes out, which is the baby’s first stool which is generally greenish-black. Normally, meconium will be expelled in less than 24 hours after the baby is born. If a baby is unable to pass meconium within 24 to 48 hours, it most likely has Hirschsprung’s disease. Therefore, the timing of meconium discharge in infants must really be considered.
Conversely, what will happen if Hirschsprung’s disease is not detected or treated too late? This disease can cause other complications, such as enterocolitis or inflammation of the intestine, sepsis, to shock. In this case, the feces will accumulate in the intestine, then there is a large intestinal obstruction, ileal obstruction, until finally the intestine becomes full of feces so that the stomach looks enlarged. If left too long, sufferers of this disease can experience vomiting caused by full intestines so that food cannot enter. Then, sufferers can experience fluid loss which can continue to become dehydrated, over time shock can occur in the form of a significant drop in blood pressure.
What needs to be known is that the length of the aganglionic segment can vary in the sufferer and is divided into four levels. ultrashort segment, i.e. the absence of a nerve ganglion at 1 to 2 centimeters from the rectum; Short segment, namely the absence of nerve ganglia in the rectum and sigmoid colon; Long segment, involving most of the colon; Total, namely the absence of nerve ganglia throughout Slot Gacor Maxwin the large intestine and sometimes extending to the small intestine, is also called Zuezler-Wilson syndrome. In Hirschsprung’s case with a short segment, the feces can still be pushed up by the peristalsis of other intestinal segments so that the sufferer can still defecate, but it is rare and more like constipation, in fact this disease may only be detected when he is an adult. Although short, intestinal obstruction can also occur if this condition is left unchecked.
The main treatment for this disease is cutting the part of the intestine that does not have a nerve ganglion through a surgical procedure. The pediatric surgeon will discuss this with the patient’s parents in advance, whether the patient will be observed or immediately undergo surgery. The surgical procedures performed are different. Some patients can recover with just one operation, but there are also patients who must be fitted with a stoma first. Stoma is a hole made in the intestine through the patient’s stomach to remove feces which will be accommodated in a bag. Generally, after one or several operations, the patient can recover permanently, except if there is still an aganglionic segment that was not removed during surgery.
We all need to be more aware of Hirschsprung’s disease, especially in newborns. Pay attention to the time of meconium discharge and other signs, so that we can take action more precisely and quickly. Hopefully HOLA, CIMSA this time will be useful, stay safe, stay healthy, and be active with CIMSA UPH !
