Ileus (Hirschsprung´s Disease)

obst_11a_n.jpg: Already suckling newborn with a large belly, cyanosis of the lips, and apparative surveillance. The large abdomen is caused by a low obstructive ileus. There is a hypersonorous resonance on percussion which points to a high content of air within the intestine or abdominal cavity. There is a discrepancy between the size of the thorax and the protuded abdomen, leading to a high position of the diaphragm and to secondary respiratory distress syndrome ($$atno_8??££alternate picture§§). obst_11b_n.jpg: Effect of a tube introduced into the anal channel. Air is evacuated under pressure (notice the splash on the napkin) and the stool which is not normal, although the child is suckled (it should be golden-yellow, ointment-like and aromatically smelling). The application of a rectal tube and the irrigations of the intestine lead to an immediate relief of the large abdomen. The clinical suspicion of Hirschsprung's disease was confirmed by this simple measure; emergency surgery is mostly unneccessary in these cases. The stool color (dark-yellow and brown elements), consistency (granular and viscous), and odor (malodorous) is not normal and fits Hirschsprung's disease.