PEDS at NEMC

My patient this week was a 14 yo Hispanic girl with Hirschsprungs Disease. This is a congenital disease where part of the colon is missing nerves. Without those nerves peristalsis does not happen. The result is constipation and impaction with a distended abdomen. In an infant they may not pass meconium; if older and the section is relatively small they may only suffer constipation and bloating until things plug up. The Tx is removal of non-innervated section with a colostomy. Later the colostomy can be reversed. This was the case with my patient. She was 2 days post colostomy takedown. On thursday her IV and meds were D/C so I only gave Lortab PO. On Friday she was d/c'd. Peds is a slow floor after renal :)