A 20 days old neonate with distension of abdomen , at ultrasound showed - slight narrowing of rectum ( dotted arrow ) & gross distension of sigmoid & descending colon ( arrow ) , & mild distension of entire colon. Rest of the abdomen was unremarkable . On the basis of USG findings low (rectal) obstruction suspected with colonic distension , & possibility of Hirschsprung disease proposed . On barium enema study classical findings of narrowing with coning ( zone of transition ) & distension of sigmoid noted , which supported further the diagnosis . The case underwent primary colostomy with rectal biopsy , which confirmed aganglionic nature Hirschsprung disease .
Fig-1 suprapubic US scan shows rectal narrowing with coning ( dotted arrow ) , & distended sigmoid ( small arrow ) . UB seen empty . The image classically similar to barium study .
Fig 2 - Quad US scan shows distended sigmoid , descending & other parts of colon with rectal narrowing .
Fig 3 - Lateral barium enema radiograph
Fig 4- AP barium enema radiograph
Both fig 3 & 4 barium enema radiographs
shows narrowing of rectum with coning / funnelling of zone of transition & distended sigmoid colon , classical for Hirschsprung disease .
Case 2-
TAKE HOME- To diagnose Hirschsprung disease in neonatal period is quite feasible and rewarding. The liquid meconium in colon & recto-sigmoid region acts as a contrast ( echogenic liquid in bowel) during sonography & can delineate the rectal narrowing ( stricture as beak sign) with proximal sigmoid distension. In the late age the constipated & fecal matter loaded sigmoid obscures the stricture details due to fecal matter & gas shadowing .
PS - Barium enema radiographic images & operative f/up courtesy : Dr Gaurav Bahety , M. Ch. pediatric surgeon , Bhilwara ( raj , India )
It was during my research on HIV/Herpes that I stumbled upon the Hiv/Herpes information; information which is quite easy to find when doing a search for STD on google. I was into conspiracy at the time thought of HIV/Herpes Cured' being a conspiracy was something Ignorance though,I found pretty interesting about herbal medicine. I asked questions about the Herbal cure's on official HIV/Herpes websites and I was banned for doing so by moderators who told me that I was parroting Hiv/Herpes propaganda. This reinforced my belief that there is a cure for Hiv/Herpes Then i found a lady from germany name Achima Abelard Dr Itua Cure her Hiv so I send him a mail about my situation then talk more about it and send me his herbal medicine I drank for two weeks.And today I'm Cured no Hiv/Herpes in my life,I searched for Hiv/Herpes groups to attempt to make contact with people in order to learn more about Hiv/Herpes Herbal Cure's I believed at this time that you with the same disease this information is helpful to you and I wanted to do the best I could to spread this information in the hopes of helping other people.That Dr Itua Herbal Medicine makes me believes there is a hope for people suffering from,Parkinson's,Alzheimer’s disease,Bechet’s disease,Crohn’s disease
ReplyDelete,Cushing’s disease,Heart failure,Multiple Sclerosis,Hypertension,Colo_Rectal Cancer,Lyme Disease,Blood Cancer,Brain Cancer,Breast Cancer,Lung Cancer,Kidney Cancer,Love Spell,psoriasis,Lottery Spell,disease,Schizophrenia,Cancer,Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity Syndrome Fibrodysplasia Ossificans Progressiva.Infertility,Tach Disease ,Epilepsy ,Diabetes ,Coeliac disease,,Arthritis,Amyotrophic Lateral Sclerosis,Autism,Alzheimer's disease,Adrenocortical carcinoma.Asthma, (measles, tetanus, whooping cough, tuberculosis, polio and diphtheria)Allergic diseases.Parkinson's disease,Schizophrenia,Lung Cancer,Breast Cancer,Colo-Rectal Cancer,Blood Cancer,Prostate Cancer,siva.Fatal Familial Insomnia Factor V Leiden Mutation ,Epilepsy Dupuytren's disease,Desmoplastic small-round-cell tumor Diabetes ,Coeliac disease,Creutzfeldt–Jakob disease,Cerebral Amyloid Angiopathy, Ataxia,Arthritis,Amyotrophic Lateral Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity
Syndrome Fibrodysplasia Ossificans ProgresSclerosis,Seizures,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic diseases.Hiv_ Aids,Herpe ,Copd,Glaucoma., Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.
Dementia.,Hiv_ Aids,Herpes,Inflammatory bowel disease ,Copd,Diabetes,Hepatitis,I read about him online how he cure Tasha and Tara,Conley,Mckinney and many more suffring from all kind of disease so i contacted him . He's a herbal doctor with a unique heart of God, Contact Emal..info@drituaherbalcenter.com / drituaherbalcenter@gmail.com Phone or whatsapp..+2348149277967.