Abstract
Intestinal neuronal dysplasia type B (IND B) represents a congenital malformation of the enteric nervous system causing disorders of intestinal motility, e. g., chronic constipation. We report a newborn who primarily suffered from intussusception and peritonitis. He required a subtotal colectomy for gangrene, but since IND B had not been expected at this time, no specific immunhistochemical workup for IND was initiated. Following recurrent episodes of ileus and subileus within the next years, colonic biopsies were taken and histotopochemical staining revealed IND B. The remaining colon required resection; an ileorectostomy was performed and the patient is now asymptomatic. This case report discusses the causality of IND B for intussusception and stresses that in newborn patients the clinical presentation may be misleading, and adequate histochemical evaluation is essential for early detection.
References
Borcbard F, Meier-Ruge W, Wiebecke B et al (1991) Innervationsstörungen des Dickdarms — Klassifikation und Diagnostik. Pathologe 12: 171–174
Gil-Vemet JM, Marhuenda C, Salas A, Casasa J, et al (1994) Consideration regarding the treatment of non-aganglionic congenital intestinal neuropathies. Cir Pediatr 7: 8–10
Hanimann B, Inderbitzin D, Briner J, Sacher P (1992) Clinical relevance of Hirschsprung-associated neuronal intestinal dysplasia (HANID). Eur J Pediatr Surg 2: 147–149
Koletzko S, Balauff A, Hadziselimovic F, Enck P (1993) Is histological diagnosis of neuronal intestinal dysplasia related to clinical and manometric findings in constipated children? Results of a pilot study. J Pediatr Gastroenterol Nutr 17: 59–65
Krebs C, Silva MC, Parra MA (1991) Anorectal electromanometry in the diagnosis of neuronal intestinal dysplasia in childhood. Eur J Pediatr Surg 1: 40–44
Meier-Ruge W (1992) Epidemiology of congenital innervation defects in the distal colon. Virchows Archiv A Pathol Anat 420: 171–177
Sacher P, Briner J, Hanimann B (1993) Is neuronal intestinal dysplasia (NID) a primary disease or a secondary phenomenon? Eur J Pediatr Surg 3: 228–230
Schärli AF (1992) Neuronal intestinal dysplasia. Pediatr Surg Int 7: 2–7
Schmittenbecher PP, Schmidt A, Joppich I (1993) Kinderchirurgisch relevante chronisch-obstipative Defäkationsstörungen. Kinderärztl Praxis 61: 250–257
Simpser E, Kahn E, Kenigsberg K, Duffy L, Markowitz J, Daum F (1991) Neuronal intestinal dysplasia: quantitative diagnostic criteria and clinical management. J Pediatr Gastroenterol Nutr 12: 61–64
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Till, H., Schmittenbecher, P.P., Schmidt, A. et al. Ileocolic intussusception: an unusual complication in a newborn with intestinal neuronal dysplasia. Pediatr Surg Int 11, 574–576 (1996). https://doi.org/10.1007/BF00626071
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DOI: https://doi.org/10.1007/BF00626071