Residual Hirschsprung’s Disease in Adulthood: Management Challenges at a Nigerian Tertiary Hospital - A Case Report

Abstract

Background: Hirschsprung’s disease (HD)is a developmental condition that is found mainly in the paediatric population. However, a few of them can still present to adult surgeons with a residual aganglionic intestinal segment despite an initial operative intervention. Challenges in management occur largely from the paucity of surgical experience when compared with the paediatric population.

Case Report: A 21-year-old man presented to our adult emergency room 13 years after a trans-anal pull-through with features of obstruction. The patient was diagnosed with residual HD. He underwent an initial colostomy followed by the Duhamel procedure which was complicated by anastomotic dehiscence. He subsequently had an ileostomy which was reversed after four months when there was no contrast extravasation at the site of anastomosis.

Conclusion and Recommendations: Here, we present our experience in the management of a patient with residual Hirschsprung’s disease who was successfully managed with a two-stage approach after a failed single-stage attempt. This report highlights the challenges of incomplete resection of HD in the paediatric age group presenting to the general surgeon in adult life.