Swenson’s operation is done for:
Correct Answer: Hirschsprung disease
Description: Ans: a (Hirshsprung disease) Ref: Bailey and Love, 24th ed, p. 1154-1155; Schwartz, 8th ed, p. 1496HIRSCHSPRUNG DISEASE* Also called aganglionic megacolon.* Congenital disorder due to absence of ganglion cells in the neural plexus (myentric plexus) of the intestinal wall together with hypertrophy of nerve trunks.* Due to failure of migration of neuroblasts into the gut from vagal nerve trunks at the end of 1st trimester of fetal life.* MC site is rectosigmoid (or more specifically rectum)* C/F varies from a/c intestinal obstruction in neonates to c/c constipation in later life.* One important feature which distinguishes HD from other types of constipation is that fecal soiling is not a feature of HD.* M:F RATIO IS 4:1.* Absence of ganglion cells give rise to a contracted non peristaltic segment with a dialated hypertrophic segment of normal colon above it.DIAGNOSIS1. Rectal biopsy - Full thickness biopsy and demonstration of aganglionosis and hypertrophic trunks.2. Anorectal manometry - Useful screening test in constipated young child and adult who is otherwise fit.3. Radiology - Erect and supine abdominal radiographs are useful.TREATMENTTreatment of choice - A pull through procedure in which normally innervated colon is anastamosed to the distal rectum just above the internal sphincter thus bypassing contractile non peristaltic segment and restoring normal defecation.OTHER NAMED OPERATIONS1. Duhamel's operation 2. Swenson's operation 3. Soave procedure.
Category:
Surgery
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