Pneumoperitoneum in in-vitro Conceived Quadruplet Neonate: Rare Manifestation of Hirschsprungʼs Disease – Report of a Case

Mihanović, Jakov; Jurić, Ivo; Pogorelić, Zenon; Mrklić, Ivana; Jukić, Miro; Furlan, Dubravko

doi:10.14712/18059694.2016.7

Acta Medica > Archive > 2015, Vol. 58 > Issue 4 > Pneumoperitoneum in in-vitro Conceived…

Acta Med. 2015, 58: 144-146

https://doi.org/10.14712/18059694.2016.7

Pneumoperitoneum in in-vitro Conceived Quadruplet Neonate: Rare Manifestation of Hirschsprungʼs Disease – Report of a Case

Jakov Mihanović^a, Ivo Jurić^b, Zenon Pogorelić^b, Ivana Mrklić^c, Miro Jukić^b, Dubravko Furlan^b

^aDepartment of Surgery, General Hospital Zadar, Zadar, Croatia
^bDepartment of Pediatric Surgery, Split University Hospital and Split University School of Medicine, Split, Croatia
^cDepartment of Pathology, Split University Hospital and Split University School of Medicine, Split, Croatia

Received August 20, 2015
Accepted September 20, 2015

Introduction: Hirschsprung’s disease is a congenital colonic aganglionosis, usually presented as inability or difficulty in passing of meconium, chronic and persistent obstipation, maleficent feeding, vomiting, distension and lethargy. Case presentation: We presented a case of an in-vitro conceived quadruplet premature neonate who presented with pneumoperitoneum caused by transverse colon spontaneous perforation and microcolon appearance of distal bowel, treated by resection and temporary colostomy turns to be a rare manifestation of Hirschsprung’s disease. Conclusion: Assisted reproductive technologies increases chances for multiple pregnancies and may increase chance for major congenital anomalies. Rare manifestation of Hirschsprung’s disease is spontaneous pneumoperitoneum which remains a surgical emergency. Delay in recognizing and treatment can significantly worsen prognosis. In neonate with intestinal perforation one should consider Hirschsprung’s disease.