You're going to the OR electively, and you're ready to do your pull through, and you biopsy your sigmoid in your left colon, you get no ganglion cells. In my opinion, you should not do a pull through that day because you want to be absolutely certain that you have permanent section before you throw out any useless colon.
When going to OR electively for pull-through and finding no ganglion cells in sigmoid or left colon, the surgeon should not proceed with pull-through that day but should biopsy transverse colon and hepatic flexure, perform ileostomy with frozen section confirmation, and return another day for definitive surgery with permanent sections.
clinicalThe septic source in Hirschsprung disease is not the dilated bowel itself but the Hirschsprung enterocolitis, making IV metronidazole critical.↗
▶Ep 226 · 19:30
clinicalWhen going to OR electively for pull-through and finding no ganglion cells in sigmoid or left colon, the surgeon should not proceed with pull-through that day but should biopsy transverse colon and hepatic flexure, perform ileostomy with frozen section confirmation, and return another day for definitive surgery with permanent sections.↗
▶Ep 226 · 19:30
quoteYou're going to the OR electively, and you're ready to do your pull through, and you biopsy your sigmoid in your left colon, you get no ganglion cells. In my opinion, you should not do a pull through that day because you want to be absolutely certain that you have permanent section before you throw out any useless colon.↗
Philippa's statements about Hirschsprung disease3 statements
clinicalThe septic source in Hirschsprung disease is not the dilated bowel itself but the Hirschsprung enterocolitis, making IV metronidazole critical.↗
▶Ep 90 · 19:30
quoteYou're going to the OR electively, and you're ready to do your pull through, and you biopsy your sigmoid in your left colon, you get no ganglion cells. In my opinion, you should not do a pull through that day because you want to be absolutely certain that you have permanent section before you throw out any useless colon.↗
▶Ep 90 · 19:30
clinicalWhen going to OR electively for pull-through and finding no ganglion cells in sigmoid or left colon, the surgeon should not proceed with pull-through that day but should biopsy transverse colon and hepatic flexure, perform ileostomy with frozen section confirmation, and return another day for definitive surgery with permanent sections.↗
Philippa's statements about Trisomy 213 statements
clinicalThe septic source in Hirschsprung disease is not the dilated bowel itself but the Hirschsprung enterocolitis, making IV metronidazole critical.↗
▶Ep 5 · 19:30
quoteYou're going to the OR electively, and you're ready to do your pull through, and you biopsy your sigmoid in your left colon, you get no ganglion cells. In my opinion, you should not do a pull through that day because you want to be absolutely certain that you have permanent section before you throw out any useless colon.↗
▶Ep 5 · 19:30
clinicalWhen going to OR electively for pull-through and finding no ganglion cells in sigmoid or left colon, the surgeon should not proceed with pull-through that day but should biopsy transverse colon and hepatic flexure, perform ileostomy with frozen section confirmation, and return another day for definitive surgery with permanent sections.↗
Summaries Philippa gave as host
· 4 summaries
Recaps of other experts' statements, not Philippa's own clinical position.
Summaries Philippa gave as host · Colorectal / ARM & Hirschsprung1 summary
host summaryPhilippa Jalius summarizing the discussion: If going to OR for elective pull-through and sigmoid/left colon biopsies show no ganglion cells, should not proceed with pull-through that day; instead biopsy transverse colon and hepatic flexure, do ileostomy with frozen section confirmation, and return another day for definitive repair.↗
Summaries Philippa gave as host · Hirschsprung disease1 summary
host summaryPhilippa Jalius summarizing the discussion: If going to OR for elective pull-through and sigmoid/left colon biopsies show no ganglion cells, should not proceed with pull-through that day; instead biopsy transverse colon and hepatic flexure, do ileostomy with frozen section confirmation, and return another day for definitive repair.↗
Summaries Philippa gave as host · Hirschsprung Disease: Diagnosis to Long-Term Management1 summary
host summaryPhilippa Jalius summarizing the discussion: If going to OR for elective pull-through and sigmoid/left colon biopsies show no ganglion cells, should not proceed with pull-through that day; instead biopsy transverse colon and hepatic flexure, do ileostomy with frozen section confirmation, and return another day for definitive repair.↗
Summaries Philippa gave as host · Trisomy 211 summary
host summaryPhilippa Jalius summarizing the discussion: If going to OR for elective pull-through and sigmoid/left colon biopsies show no ganglion cells, should not proceed with pull-through that day; instead biopsy transverse colon and hepatic flexure, do ileostomy with frozen section confirmation, and return another day for definitive repair.↗
