1. What is a mega colon / hisprung disease?
Answer:
Mega colon / hisprung disease is a disease that occurs because of problems at the bottom persyarafan colon, rectum until the intestines start on it. Neural useful for making broad and narrow intestines moving normally do not exist at all or if there is very little.
2. Any symptoms that occurred in patients with mega colon / hisprung disease?
Answer:
The symptoms that occur in patients with mega colon / hisprung diseases, among others:
· In newborn babies can not remove meconium (first stool of the newborn)
· Unable to defecate within 24-48 hours after birth, distended abdomen, vomiting
· Watery diarrhea (in newborns)
· Weight loss does not increase
· Malabsorption
3. What is the cause of the occurrence of mega colon / hisprung disease?
Answer:
Some cause mega colon / hisprung diseases, among others:
· Descent, since this disease is a congenital disease
· Environmental factors
· The absence of ganglion cells in the rectum or the rectosigmoid colon
· The inability rectum sphincter relaxes
4. What about the pathophysiology of the mega colon / hisprung disease?
Answer:
Pathophysiology of mega colon / hisprung disease are:
Tues parasympathetic ganglion of the plexus in the colon aurbach no
Peristaltic segment decreased colon, rectum and colon adenoma on the bottom
Hypertrophy
Proximal part of colon distention
Abdominal distension
5. Clinical manifestation of what happens to infants and children with mega colon / hisprung disease?
Answer:
Clinical manifestations in infants and children, among others:
· Constipation
· Recurrent diarrhea
· Feces such as pipes, foul-smelling
· Abdominal distension
· Failure to thrive
6. Nursing diagnosis or problem of what happens in children with mega colon / prapembedahan hisprung disease?
Answer:
Nursing diagnosis or problems that occur in children with mega colon / prapembedahan hisprung disease, among others:
· Constipation
· Less volume of fluid and electrolyte
· Impaired nutritional needs
· Impaired growth and development
7. Any examination of common practice in patients with mega colon / hisprung disease?
Answer:
Regular checks to be performed in patients with mega colon / hisprung diseases, among others:
· Abdominal x-ray (showing widening of the large intestine is filled by gas and feces)
· Barium enema
· Anal manometry (measurement of the anal sphincter pressures by developing a balloon in the rectum)
· Biopsy of rectum (indicating the absence of ganglion nerve cells)
8. Explain the management of patients mega colon / hisprung disease?
Answer:
Management of patients with mega colon / hisprung diseases, among others:
· Surgery:
Surgery on the mega colon / hisprung disease was performed in two stages. First performed loop or double barrel colostomy so tonus and size of intestinal dilatation and hypertrophy may be back to normal (it takes approximately three to four months).
· Conservative
In neonates with intestinal obstruction performed conservative therapy and gastric sonde through the installation of pipes to remove the meconium and rectal air.
· Surgery while
This was done in neonatal patients, children and adult patients who terlambst diagnosed and patients with severe enterocolitis. Colostomy was made in the normal colonic berganglion the most distal.
9. Treatment is performed in patients with mega colon / hisprung disease?
Answer:
Maintenance performed on patients with mega colon / hisprung diseases, among others:
· In the case of stable, use of laxatives and also most of the dietary modification and manure is an effective form
· Corticosteroid drug and anti-inflammatory drug used in toxic mega colon. This medicine does not condense and is not pressing feces using anorectal and nasogastrik tuba.
10. What is the purpose for which rectal biopsy examination in patients with mega colon / hisprung disease?
Answer:
Examination of rectal biopsy is used to detect the presence or absence ganglion cells.
11. What results obtained from radiological examinations in patients with mega colon / hisprung disease?
Answer:
Results obtained on radiological examination are:
· On plain abdominal images show obstruction at the distal and proximal colonic dilatation
· On barium enema images give the same picture is accompanied by the transition region between the narrow segment with a segment on the distal part of the dilatation on the proximal part. If there is no transition region, mega colon disease diagnosis / disease hisprung enforced by looking at slowing the evacuation of barium because peristaltic disorders.
12. Explain three procedures are performed in the surgical management of patients with mega colon / hisprung disease?
Answer:
Three procedures in surgery including:
· Duhamel procedure
By way of withdrawal under the direction of normal colon and colon aganglionik menganastomosiskannya behind, making a double wall of the sheath aganglionik and the posterior part of the normal colon which has been withdrawn
· Swenson procedure
Discard the aganglionik then menganastomosiskan end to end on a berganglion colon with anal canal and cutting the sphincter dilation performed on the posterior part
· Soave procedure
By way of letting the muscle wall of the rectum segment remains intact then the bersaraf normal colon is pulled up to the location of the anal anastomosis between normal colon and the remaining muscle tissue rektosigmoid
13. What is the cause mega colon disease / illness hisprung that occurs in adults?
Answer:
Mega colon / penykit hisprung in adults can be caused by
· Taking certain drugs
· Abnormal thyroid function
· Diabetes mellitus
14. What complications can occur in patients with mega colon / hisprung disease?
Answer:
Enterocolitis is a severe complication of mega colon disease / illness hisprung with high mortality rates
15. Any action plans are given for each possible diagnosis are enforced on patients prapembedahan mega colon / hisprung disease?
Answer:
Action plan based on the diagnosis given, among others:
· Constipation
Actions:
a. Monitoring of bowel function and fecal characteristics
b. Give spoling with saline water when no other contraindications
c. Collaboration with the doctor about surgery plans
· Less volume of fluid and electrolyte
Actions:
a. Perform monitoring of hydration status by measuring intake and output of body fluids
b. Observation of mucous membranes, skin turgor, urine production, and fluid status
c. Collaboration in the provision of fluids in accordance with the indications
· Impaired nutritional needs
Actions:
a. Monitor changes in nutritional status among other skin turgor, intake
b. Do parenteral nutrition if oral not possible
c. Weigh daily weight
d. Perform high nutrition with calories, and high protein
16. Diagnosis of what can be enforced in the post-surgical patients with mega colon / hisprung disease?
Answer:
Diagnostics that can be enforced after the surgery, among others:
· Painful
· Risk of infection
· The risk of post-surgical complications
17. What is the purpose examination in patients with anorectal manometry mega colon / hisprung disease?
Answer:
Anorectal manometry examination is used to record the responses of internal and external sphincter reflux
18. Why pain can occur in patients post-surgery mega colon / hisprung?
Answer:
Pain may occur due to the effects of post-surgical incision, this can be indicated by signs of pain such as expression of feeling pain, changes in vital signs, restriction of activities.
19. What to do if the mega colon / hisprung occurred in infants aged 6-12 months?
Answer:
When a baby is between 6-12 months of age, was done by cutting the intestine and menganastomisikan aganglionik berganglion colon to rectum with a distance of 1 cm from the anus.
20. What is a mega colon / hisprung disease and mega-long segment of colon / hisprung short segment disease?
Answer:
Referred to as mega colon / disease hisprung long segment aganglionosis beyond the sigmoid segment where until the entire colon.
While that is a mega colon / disease hisprung short segment aganglionosis if the segment starting from the anus to the sigmoid.
REFERENCES
Dudley, Hugh A. F (Ed). 1992. Emergency Surgery. Yogyakarta: Gadjah Mada University.
Isselbacher, et al. 2000. Harrison’s Principles of Internal Medicine Sciences. Jakarta: EGC.
Rudolph, Abraham M., et al. Textbook Paediatrics Rudolph. Jakarta: EGC.
Sabiston. 1994. Surgical Textbook. Jakarta: EGC.
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