EUS-guided fistulization of postoperative colorectal stenosis in an infant with Hirschsprung's disease: a new technique

Use of covered self-expandable stents for benign colorectal disorders in children

“…Like in our cohort, two patients in other literature reports suffered from sequelae associated with Hirschsprung's disease [8,9]. Rullán et al [8] reported on a male infant who developed a rectal stricture following a Soave pull-through operation.…”

“…The stent was removed after 2 months and the child improved significantly without further obstructive symptoms. Three months later he underwent definite surgery [9]. This case together with our cohort illustrates that in patients with poor nutritional status caused by previous therapy a stent can be used in order to improve the clinical condition and to avoid emergency surgery.…”

“…With regard to the pediatric population stenting for benign esophageal conditions seems to become a promising tool particularly for anastomotic strictures and leaks post esophageal atresia repair and perforations after dilatation [10,12,13]. However, recent literature revealed only a few case reports dealing with the application of selfexpandable stents for benign colorectal disorders in children [7][8][9]. In 2004 Hussein and colleagues were the first who described a case of a 15-year-old boy in whom an esophageal SEMS was inserted for acute colonic obstruction caused by a rare metastatic desmoplastic tumor of the posterior abdominal wall.…”

“…Another literature report described the application of a biliary SEMS in a 3-year-boy who underwent a Duhamel-Haddad procedure for Hirschsprung's disease and subsequently developed a colonic obstruction [9]. The initial operation had been complicated by a leak of the colorectal anastomosis, and a diverting ileostomy was performed.…”

“…However, physicians dealing with this group of patients have just begun to explore the use of self-expandable stents and up to now data are limited to a few case reports only [7][8][9].…”