Neonatal Surgery
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Reviewed by Charge Nurse - Newborn and Carl Kuschel and Mr Philip Morreau (Surgery) |
| January 2005 |
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| Preoperative Care | Postoperative Care | Index of Related Documents |
Hirschprung's Disease is a congenital absence of normal ganglionic cells in the mesenteric plexus of the bowel, resulting in abnormal peristalsis. It may present with delayed passage of meconium (after 24 hours of birth), or may present as an enterocolitis. In older children, it may present as chronic constipation.
| Step | Action |
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1 |
Follow standard pre-operative care guideline and the guideline for infants with necrotising enterocolitis. |
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2 |
Rectal temperatures may assist. |
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3 |
Dilatations of the rectum should be performed as directed by the surgeon, with rectal washouts using 10ml/kg of 0.9% NaCl. |
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4 |
Bowel preparation may be required (instructions will be provided by the surgeon). |
Follow the steps below to ensure safety of baby postoperatively.
| Step | Action |
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1 |
Follow standard steps for postoperative care and the necrotising enterocolitis guideline. |
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2 |
No rectal temperatures. |
| 3 | The retro-rectal drain is removed on the 2nd or 3rd post-operative day as per the surgeon's instructions. |
| 4 | There may be a single stage repair in which case the baby will be discharged and readmitted 2-weeks later for an examination under anaesthesia, then commence twice-daily dilatations. |
| 5 | If a colostomy has been fashioned, the baby will be discharged and will require weekly washouts with normal saline of the distal stoma. The baby will later be admitted for a pull-through procedure and closure of the colostomy. |
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