Possible Newborn Health Problems
Gastro-intestinal Tract Disorders
Unusual Blood Results
Hirschsprungs disease occurs when some
of the large intestine does not have the usual nerve supply.
The medical term for this is aganglionic.
The part of the intestine without a nerve
supply cannot relax. It remains collapsed, shut tight and is
unable to squeeze, so faeces cannot be passed.
Eventually the pressure of faeces is so high
that some are forced through the obstruction.
Hirschsprungs disease occurs in the
last part of the intestine (often the rectum and sigmoid colon)
and always ends at the anus. In some children, the length of
intestine involved is shorter or longer.
Babies with Hirschsprung's disease may not
pass meconium in the first two days of life.
They usually develop abdominal swelling and
vomiting in the first few days after birth and may become very
unwell with enterocolitis, a severe inflammatory condition of
These babies need
a tube into the stomach
a heart echo
to be in a paediatric surgery centre
A barium enema x-ray of the large intestine;
may show a swollen part of the intestine
in front of a narrow collapsed part of the intestine
may look normal if a very short or
very long part of bowel is affected
A biopsy a tiny sample of the rectum
is pinched away and looked at under a microscope; the baby has
Hirschsprung's disease if no nerve cells are seen.
Surgery for Hirschsprungs disease is
needed within the newborn period.
This may be
one "pull-through" operation;
to remove the aganglionic bowel
bring the healthy intestine down into the rectum, and
join it to the rectal wall
two or three operations;
to create a temporary colostomy; the colon is brought
out to the surface of the abdomen so that faeces can be expelled.
The baby is allowed to grow for several months
a pull-through operation brings the healthy intestine
down into the rectum, and joins it to the rectal wall; the rectum
is "pulled down"
colostomy may be closed
to close the colostomy if not closed in second operation
After the operation, the baby will need a
few days in the neo-natal intensive care unit, then a few weeks
in hospital until feeding is going well and there are no other
Further operations will be in the paediatric
department of the hospital.
After surgery the child will continue to have
check-ups with the paediatric surgeon to check that the child
has no intestinal problems and when older to check the child
is gaining good bowel control.